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【目的】探讨体外反搏治疗失血性休克的机制。【方法】动物随机分为 3组 :假手术对照组、失血休克组及失血休克加体外反搏组。采用一侧颈总动脉插管放血制造重症失血性休克模型。实验结束时取心肌及主动脉组织测一氧化氮合酶(NOS)、超氧化物歧化酶 (SOD)、丙二醛 (MDA)、腺苷三磷酸 (ATP)、糖原及乳酸等指标。【结果】①反搏组反搏后平均血压显著高于反搏前 ,且实验结束时反搏组的血压也显著高于失血组。②假手术对照组及反搏组心肌组织NOS活性均显著高于失血休克组。③假手术对照组及反搏组心肌组织MDA含量均显著低于失血组 ,且SOD活性均显著高于失血组。④假手术对照组及反搏组心肌组织ATP水平也显著高于失血组。【结论】体外反搏可以增强心肌NOS活性 ,从而改善心肌供血 ,并能提高心肌对自由基的清除能力 ,减轻自由基损伤 ,同时改善心肌的能量供应
【Objective】 To explore the mechanism of external counterpulsation for hemorrhagic shock. 【Methods】 The animals were randomly divided into 3 groups: sham-operated control group, hemorrhagic shock group, and hemorrhagic shock plus extra-corporepuncture group. One side of common carotid arteries to produce bleeding in severe hemorrhagic shock model. At the end of the experiment, the indexes of nitric oxide synthase (NOS), superoxide dismutase (SOD), malondialdehyde (MDA), adenosine triphosphate (ATP), glycogen and lactic acid were measured in myocardium and aorta. [Results] ① The mean blood pressure after counterpulsation in EECP group was significantly higher than that before EECP, and the ECP group’s blood pressure was also significantly higher than that in the blood loss group at the end of the experiment. ② The NOS activity in cardiac muscle of sham operation control group and EECP group was significantly higher than that in hemorrhagic shock group. ③ The contents of MDA in myocardium of sham operation control group and EECP group were significantly lower than that of the control group and the activity of SOD was significantly higher than that of the control group. ④ The sham operation control group and the EECP myocardial tissue ATP level was also significantly higher than the blood loss group. 【Conclusion】 Extracorporeal cardiopulmonary bypass can enhance myocardial NOS activity, thereby improving myocardial blood supply, and improve the ability of myocardial free radical scavenging, reduce free radical damage, and improve myocardial energy supply