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[氢化可的松对兔脓毒症早期心肌功能的影响]

[Effects of hydrocortisone on myocardial function in early stage of sepsis in rabbits].

作者信息

Feng En-min, Sun Hua, Xia Yan-zhen

机构信息

Intensive Care Unit, Second Affiliated Hospital of Nantong University, Nantong 226001, Jiangsu, China.

出版信息

Zhongguo Wei Zhong Bing Ji Jiu Yi Xue. 2009 Dec;21(12):719-21.

Abstract

OBJECTIVE

To study the effects of different dose of hydrocortisone (HC) on myocardial function in early stage of sepsis in rabbits.

METHODS

Twenty-four male rabbits were randomly divided into three groups: model group (n=8), HC low dosage group (10 mg/kg, n=8), HC high dosage group (100 mg/kg, n=8). The model was reproduced by cecal ligation and puncture (CLP). The function of the left ventricle was monitored and blood was drawn at 5 time points [before CLP, before treatment (1 hour after CLP) and 2, 4, 6 hours after the treatment] to determine concentrations of cardiac troponin I (cTnI) and nitric oxide (NO). The expression of inducible nitric oxide synthase (iNOS) of myocytes was investigated.

RESULTS

Compared to the basic levels, maximal positive and negative change in filling pressure versus time (+/-dp/dt max) decreased significantly, while NO increased significantly before treatment in all groups (all P<0.05). At 6 hours after treatment, +/-dp/dt max in HC low dosage group was significantly higher than that in the other two groups, while cTnI was significantly lower in HC low dosage group than that in the other two groups (all P<0.05). NO content in two HC groups was significantly lower than that in model group (all P<0.05), and the iNOS expressions on myocardial cells was weaker than model group [model group: (81.8+/-15.8)%, HC low dosage group: (56.7+/-21.2)%, HC high dosage group: (54.6+/-16.1)%, all P<0.05].

CONCLUSION

Myocardial function is remarkably damaged in rabbits with sepsis. HC low dosage group exerts protective effect on myocardial cells in early stage of sepsis.

摘要

目的

研究不同剂量氢化可的松(HC)对兔脓毒症早期心肌功能的影响。

方法

将24只雄性兔随机分为三组:模型组(n = 8)、HC低剂量组(10 mg/kg,n = 8)、HC高剂量组(100 mg/kg,n = 8)。采用盲肠结扎穿刺(CLP)法复制模型。在5个时间点[CLP前、治疗前(CLP后1小时)以及治疗后2、4、6小时]监测左心室功能并采血,测定心肌肌钙蛋白I(cTnI)和一氧化氮(NO)浓度。研究心肌细胞诱导型一氧化氮合酶(iNOS)的表达。

结果

与基础水平相比,所有组治疗前充盈压随时间的最大正负变化率(+/-dp/dt max)均显著降低,而NO显著升高(均P<0.05)。治疗后6小时,HC低剂量组的+/-dp/dt max显著高于其他两组,而HC低剂量组的cTnI显著低于其他两组(均P<0.05)。两个HC组的NO含量显著低于模型组(均P<0.05),心肌细胞上的iNOS表达弱于模型组[模型组:(81.8+/-15.8)%,HC低剂量组:(56.7+/-21.2)%,HC高剂量组:(54.6+/-16.1)%,均P<0.05]。

结论

脓毒症兔的心肌功能明显受损。HC低剂量组在脓毒症早期对心肌细胞有保护作用。

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