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目的探讨七氟烷对低温环境下失血性休克猪的心肌保护作用。方法巴马小型猪32头,雌雄不限,体质量20~25 kg,按随机数字表法分为4组,每组8头。分别为假手术组(S组)、失血性休克组(HS组)、七氟烷预处理组(Pre/Sev组)和七氟烷后处理组(Post/Sev组)。监测并记录各组平均动脉压、心率和中心体温,各组分别于休克前及休克后30、60、90、120、180和240 min共7个时间点采集血液,采用ELISA法检测血清中白细胞介素-6(interleukin 6,IL-6)、肿瘤坏死因子-α(tumour necrosis factorα,TNF-α)和超氧化物歧化酶(superoxide dismutase,SOD)的含量。结果与S组比较,HS组、Pre/Sev组和Post/Sev组血浆中TNF-α和IL-6含量在休克后60 min和90 min显著升高(P<0.05),其中TNF-α含量在休克120 min时达到高峰,休克180 min时显著低于120 min(P<0.05);血清中SOD含量显著降低(P<0.05)。与HS组比较,Pre/Sev组和Post/Sev组血浆中TNF-α和IL-6含量显著降低(P<0.05);血清中SOD含量显著升高(P<0.05)。Pre/Sev组和Post/Sev组各项比较差异无显著意义(P>0.05)。结论七氟烷对低温环境下失血性休克猪心肌具有保护作用,其主要机制与抑制炎症反应,增强机体抗氧化能力有关。
Objective To investigate the myocardial protective effect of sevoflurane on hemorrhagic shock piglets under hypothermia. Methods Bama miniature pig 32, male or female, body weight 20 ~ 25 kg, according to random number table divided into 4 groups, each group of eight. They were sham operation group (S group), hemorrhagic shock group (HS group), sevoflurane preconditioning group (Pre / Sev group) and sevoflurane postconditioning group (Post / Sev group). The mean arterial pressure, heart rate and central body temperature of each group were monitored and recorded. Blood was collected at 7 time points of 30, 60, 90, 120, 180 and 240 min before shock and after shock in each group. Serum leukocytes (IL-6), tumor necrosis factor-α (TNF-α) and superoxide dismutase (SOD). Results Compared with S group, the levels of TNF-α and IL-6 in HS group, Pre / Sev group and Post / Sev group were significantly increased at 60 min and 90 min after shock (P <0.05) Peaked at 120 min in shock, and significantly lower than that in 120 min at 180 min (P <0.05). The content of SOD in serum decreased significantly (P <0.05). Compared with HS group, the levels of TNF-α and IL-6 in Pre / Sev group and Post / Sev group were significantly decreased (P <0.05), while the content of SOD in serum was significantly increased (P <0.05). There was no significant difference between Pre / Sev group and Post / Sev group (P> 0.05). Conclusion Sevoflurane has a protective effect on myocardium of pigs with hemorrhagic shock in hypothermia environment. The main mechanism of sevoflurane is to inhibit the inflammatory reaction and enhance the antioxidant capacity.