Lee Chien-Chang, Lee Meng-Tse Gabriel, Chang Shy-Shin, Lee Si-Huei, Huang Yu-Chi, Yo Chia-Hung, Lee Shih-Hao, Chen Shyr-Chyr
Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taoyuan, Taiwan; Department of Family Medicine and Emergency Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
PLoS One. 2014 Apr 23;9(4):e95821. doi: 10.1371/journal.pone.0095821. eCollection 2014.
The aim of this study is to compare the effect of lactated ringer (LR), vasopressin (Vaso) or terlipressin (Terli) on uncontrolled hemorrhagic shock (UHS) in rats.
48 rats were divided into four treatment groups for UHS study. Vaso group was given bolus vasopressin (0.8 U/kg); the Terli group was given bolus terlipressin (15 mcg/kg); LR group was given LR and the sham group was not given anything. Mean arterial pressure (MAP), serum lactate level, plasma cytokine levels, lung injury and mortality are investigated for these different treatment groups.
Compared with LR group, vasopressin and terlipressin-treated groups were associated with higher MAP, lowered mortality rates, less lung injury, lowered serum lactate level, less proinflammatory and more anti-inflammatory cytokine production at certain time points. Comparing between vasopressin and terlipressin treated groups, there is no statistical difference in mortality rates, lung injury, serum lactate level and cytokine level. However, there is a difference in the length of time in maintaining a restored level of MAP (80 to 110 mmHg). The terlipressin treated rats can maintain this restored level of MAP for 45 minutes, but the vasopressin treated rats can only maintain this restored level of MAP for 5 minutes before decreasing gradually to the MAP observed in LR group (40 mmHg).
Early optimization of hemodynamics with terlipressin or vasopressin in an animal model of UHS was associated with improved hemodynamics and inflammatory cytokine profile than the LR control. Compared with vasopressin, terlipressin has the advantage of ease of use and sustained effects.
本研究旨在比较乳酸林格液（LR）、血管加压素（Vaso）或特利加压素（Terli）对大鼠失血性休克（UHS）的影响。
将48只大鼠分为四组进行UHS研究。Vaso组给予血管加压素推注（0.8 U/kg）；Terli组给予特利加压素推注（15 mcg/kg）；LR组给予LR，假手术组不给予任何处理。对这些不同治疗组的平均动脉压（MAP）、血清乳酸水平、血浆细胞因子水平、肺损伤和死亡率进行研究。
与LR组相比，血管加压素和特利加压素治疗组在某些时间点MAP较高、死亡率较低、肺损伤较轻、血清乳酸水平较低、促炎细胞因子产生较少且抗炎细胞因子产生较多。比较血管加压素和特利加压素治疗组，死亡率、肺损伤、血清乳酸水平和细胞因子水平无统计学差异。然而，在维持恢复的MAP水平（80至110 mmHg）的时间长度上存在差异。特利加压素治疗的大鼠可维持该恢复的MAP水平45分钟，但血管加压素治疗的大鼠只能维持该恢复的MAP水平5分钟，然后逐渐降至LR组观察到的MAP（40 mmHg）。
在UHS动物模型中，早期使用特利加压素或血管加压素优化血流动力学与比LR对照组更好的血流动力学和炎症细胞因子谱相关。与血管加压素相比，特利加压素有使用方便和持续作用的优势。
