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目的探讨脓毒血症幼猪吸入一氧化氮(nitric oxide,NO)及突然停吸NO后血流动力学的动态变化。方法幼猪8只,采用静脉注射革兰氏阴性杆菌内毒素方法诱导脓毒血症模型,幼猪吸入浓度为10cm3/m3的NO,于吸入前10min、吸入10、20、30min和停止吸入后30min应用脉波指示剂连续心排血量监测仪监测心率、心脏指数、胸腔内血容积指数和全心舒张末容积指数,并行血气分析。结果幼猪吸入NO 10、20、30min时股动脉pa(O_2)[(38.10±5.22)、(50.76±3.89)、(53.86±3.03)kPa]和心脏指数[(2.58±0.12)、(3.03±0.25)、(3.24±0.26)L/(min·m~2)]均明显高于吸入前[(55.85±3.16)kPa、(3.43±0.18)L/(min·m~2)](P<0.01);突然停吸NO后30min,pa(O_2)[(38.01±4.50)kPa]和心脏指数[(2.83±0.43)L/(min·m~2)]较吸入NO 20、30min时均明显下降(P<0.05),但仍明显高于吸入前(P<0.05);吸入NO及停吸NO期间,心率、中心静脉压、全心舒张末容积指数、胸腔内血容积指数差异均无统计学意义(P>0.05)。结论吸入低浓度NO气体对脓毒血症幼猪的氧合功能和心脏指数有明显改善,但突然停吸NO后股动脉pa(O_2)和心脏指数均下降,存在反跳现象。
Objective To investigate the dynamic changes of hemodynamics after ingestion of nitric oxide (NO) and sudden arrest of NO in septic mice. Methods Eight young pigs were induced with intravenous injection of gram-negative bacilli endotoxin to induce sepsis model. After the young pigs inhaled NO at a concentration of 10 cm 3 / m 3 for 10 min, inhaled for 10 min, 20 min, and stopped inhalation 30min pulse heart rate monitor using continuous cardiac output monitor heart rate, heart index, intrathoracic volume index and cardiac end-diastolic volume index, parallel blood gas analysis. Results Compared with control group, pa (O 2) [(38.10 ± 5.22), (50.76 ± 3.89), (53.86 ± 3.03) kPa] and cardiac index [(2.58 ± 0.12) 0.25, 3.24 ± 0.26, L / (min · m ~ 2)] were significantly higher than those before inhalation [(55.85 ± 3.16) kPa, (3.43 ± 0.18) L / (min · m ~ 0.01). PaO2 (38.01 ± 4.50) kPa and cardiac index [(2.83 ± 0.43) L / (min · m ~ 2)] were significantly higher at 30 min after inhaling NO (P <0.05), but still higher than those before inhalation (P <0.05). There was no statistical difference in heart rate, central venous pressure, endocardial end-diastolic volume index and intrathoracic blood volume index between inhaled NO and stopped-breathing NO Significance (P> 0.05). Conclusion Oxygenation and cardiac index were significantly improved in neonatal septic mice with inhalation of NO at a low concentration. However, the pa (O 2) and cardiac index of femoral artery decreased after abrupt stop of NO, and there was rebound phenomenon.