中国临床药理学与治疗学2017，Vol.22Issue(10)：1081-1089,9.
血管活性药物对脓毒症羊乳酸林格氏液体动力学的影响
Effects of vasoactive drugs on crystalloid fluid kinetics in septic sheep
摘要
Abstract
AIM:To explore how vasoactive drugs influence the distribution and clearance of lactated Ringer's solution (RL) in septic sheep.METHODS:This was a prospective randomized double-blinded study.Twenty-five experimental sheep were randomized into five groups:no drug (Control group),norepinephrine (Nor group),phenylephrine (Phe group),dopamine (Dop group),or esmolol (Esm group),with five animals for each group.After general anesthesia and tracheostomy tube for all sheep,septic model was established through cecal ligation puncture (CLP) method and a short infusion of lipopolysaccharide (LPS).Then a continuous intravenous administration of saline or corresponding vasoactive drugs were given to five groups respectively.10 min later 20 mL/kg of RL solution over 30 min was given.The kinetics of RL and the effects of covariates were calculated by plasma dilution based on dilution of hemoglobin-time curve,urinary excretion by using Phoenix software for mixed effects modeling.RESULTS:Compared with Control group,Nor group and Dop group accelerated the distribution rate from plasma to peripheral tissue (k12);while decreased the distribution rate opposite direction (k21).Adrenergic α1-receprtor accelerated,while β1-receptors retarded,the distribution and elimination of the fluid.The pharmacodynamics Emax model showed that RL increased stroke volume by 13 mL/beat,α1-receptors but not β 1-receptors further increased stroke volume,while both raised the mean arterial pressure,modulation of the β1-receptors limited the acidosis.CONCLUSION:The distribution and elimination of RL is slow in septic sheep.The tendency to peripheral accumulation of fluid is pronounced,in particular when phenylephrine and dopamine are given,and norepinephrine can alleviate acidosis.关键词
乳酸林格氏液/液体动力学/苯肾上腺素/多巴胺/去甲肾上腺素/艾司洛尔Key words
Ringer's solution/volume kinetics/phenylephrine/dopamine/norepinephrine/esmolol分类
医药卫生引用本文复制引用
易声华,李玉红,郑晓铸,安满丽,丁倩男,茹国美,张林..血管活性药物对脓毒症羊乳酸林格氏液体动力学的影响[J].中国临床药理学与治疗学,2017,22(10):1081-1089,9.基金项目
浙江省科技厅动物平台(2017C37160) （2017C37160）
绍兴市科技局公益项目(2015B70058) （2015B70058）
浙江省科技厅公益性项目(2015C33285) （2015C33285）
