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目的探讨氯胺酮在盲肠结扎穿孔术(CLP)脓毒症大鼠中对炎性介质及生存率的影响。方法将132只雄性 SD大鼠随机分为3组:①正常对照组,②对照组,③氯胺酮组。每组各分为Ⅰ、Ⅱ、Ⅲ、Ⅳ等4个亚组。对照组和氯胺酮组建立 CLP脓毒症模型。术毕30 min 开始给药,氯胺酮组经肌肉注射氨胺酮50 mg/kg,q12h;正常对照组与对照组则给予等容积的生理盐水,直至大鼠死亡或5 d 观察期结束。每组的Ⅰ亚组大鼠观察5 d 的生存情况;Ⅱ、Ⅲ、Ⅳ亚组的大鼠分别手术前0 h,术后4 h 以及对照组的Ⅳ亚组各只大鼠的临终时刻为观察时间,分别处死每组中一个亚组的大鼠测定血中肿瘤坏死因子(TNF-α)白介素-6(IL-6)的水平。结果与对照组相比,氯胺酮组的5 d 生存率明显为高(P<0.01),且氯胺酮组 TNF-α和 IL-6的血清水平在 CLP 术后4h 及临终时点均较对照组明显降低(P<0.01)。结论氯胺酮能够抑制 CLP 脓毒症大鼠血清 TNF-α、IL-6水平,从而提高大鼠的生存率。
Objective To investigate the effects of ketamine on inflammatory mediators and survival in cecal ligation and puncture (CLP) sepsis rats. Methods 132 male SD rats were randomly divided into three groups: ① normal control group, ② control group, ③ ketamine group. Each group is divided into Ⅰ, Ⅱ, Ⅲ, Ⅳ and other 4 subgroups. CLP and ketamine groups were established CLP sepsis model. Administered 30 min after operation, ketamine group was given intramuscular injection of 50 mg / kg of amines, q12h; normal control group and control group were given the same volume of saline until the rats died or 5 d observation period. The survival of rats in each subgroup Ⅰ was observed for 5 days. The rats in subgroup Ⅱ, Ⅲ and Ⅳ were killed at 0 h before surgery and at 4 h after operation, respectively. The dying time of rats in subgroup Ⅳ of control group was At the time of observation, rats in each subgroup in each subgroup were sacrificed and the levels of TNF-α and IL-6 in the blood were determined. Results Compared with the control group, the 5-day survival rate of ketamine group was significantly higher (P <0.01), and the serum levels of TNF-α and IL-6 in ketamine group were significantly higher than those in control group at 4 h and at the end of CLP Decreased (P <0.01). Conclusion Ketamine can inhibit the serum levels of TNF-α and IL-6 in CLP sepsis rats and improve the survival rate in rats.