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神经垂体对脓毒性休克大鼠高渗盐水复苏的反应。

Neurohypophyseal response to fluid resuscitation with hypertonic saline during septic shock in rats.

机构信息

Department of Physiology, Institute of Biomedical Science, Federal University of Alfenas – MG, Alfenas, Minas Gerais, Brazil.

出版信息

Exp Physiol. 2013 Feb;98(2):556-63. doi: 10.1113/expphysiol.2012.066241. Epub 2012 Aug 17.

Abstract

Septic shock is a serious condition with a consequent drop in blood pressure and inadequate tissue perfusion. Small-volume resuscitation with hypertonic saline (HS) has been proposed to restore physiological haemodynamics during haemorrhagic and endotoxic shock. In the present study, we sought to determine the effects produced by an HS infusion in rats subjected to caecal ligation and perforation (CLP). Male Wistar rats were randomly grouped and submitted to either CLP or sham surgery. Either HS (7.5% NaCl, 4 ml kg(-1) i.v.) or isotonic saline (IS; 0.9% NaCl, 4 ml kg(-1) i.v.) was administered 6 h after CLP. Recordings of mean arterial pressure and heart rate were made during this protocol. Moreover, measurements of electrolyte, vasopressin and oxytocin secretion were analysed after either the HS or the IS treatment. Six hours after CLP, we observed a characteristic decrease in mean arterial pressure that occurs after CLP. The HS infusion in these rats produced a transient elevation of the plasma sodium concentration and osmolality and increased plasma vasopressin and oxytocin levels. Moreover, the HS infusion could restore the mean arterial pressure after CLP, which was completely blunted by the previous injection of the vasopressin but not the oxytocin antagonist. The present study demonstrated that rats subjected to CLP and an infusion of hypertonic saline respond with secretion of neurohypophyseal hormones and a transient increase in blood pressure mediated by the V(1) receptor.

摘要

感染性休克是一种严重的疾病,会导致血压下降和组织灌注不足。小容量复苏用高渗盐水(HS)已被提出用于恢复出血性和内毒素性休克期间的生理血液动力学。在本研究中,我们试图确定 HS 输注对盲肠结扎和穿孔(CLP)大鼠产生的影响。雄性 Wistar 大鼠被随机分组并接受 CLP 或假手术。HS(7.5%NaCl,4ml/kg 静脉内)或等渗盐水(IS;0.9%NaCl,4ml/kg 静脉内)在 CLP 后 6 小时给予。在此方案期间记录平均动脉压和心率。此外,在 HS 或 IS 处理后分析电解质、血管加压素和催产素分泌的测量值。在 CLP 后 6 小时,我们观察到 CLP 后发生的平均动脉压特征性下降。HS 输注在这些大鼠中产生血浆钠浓度和渗透压的短暂升高,并增加了血浆血管加压素和催产素水平。此外,HS 输注可以恢复 CLP 后的平均动脉压,这完全被血管加压素而不是催产素拮抗剂的先前注射阻断。本研究表明,接受 CLP 和高渗盐水输注的大鼠通过 V1 受体分泌神经垂体激素并短暂增加血压做出反应。

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