| 摘要: |
| 目的：分析病理性氧供依赖与器官组织能量代谢间的关系，探讨该关系对器官组织氧合评价的意义。方法：以大鼠盲肠结扎穿孔(CLP)方法制作脓毒性休克模型，随机分成CLP前及CLP后2，4，5，6，7，8h组，测定氧动力学等指标后，立即处死动物并取肝、心、肾组织标本，用生物发光法测定磷酸肌酸(PC)和三磷酸腺苷(ATP)含量。结果：全身氧供给(DO2)与氧消耗(VO2)呈双相变化关系，DO2进行性降低并在CLP后6h降至临界DO2值(cDO2)，以后呈病理性氧供依赖关系。CLP后5h，肝组织PC含量明显降低(P＜0.05)，6h时肝ATP含量及肾PC、ATP含量均明显降低；心肌PC、ATP分别在CLP后6，7h始显著下降(P＜0.01)。结论：病理性氧供依赖关系的出现反映了心、肝、肾组织能量代谢障碍存在，但在其出现前，肾、肝组织已开始出现这种异常，故应尽早预防器官生物能量衰竭发生。 |
| 关键词: 氧供给 氧消耗 休克，脓毒性 |
| DOI： |
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| 基金项目: |
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| Study on relationship between pathologic oxygen supply dependency and energy metabolism in organ tissues |
| 陈克明,缪明永,景炳文,陈学云,杨兴易,单红卫 |
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| Abstract: |
| Objective：To observe the relationship between pathologic oxygen supply dependency and energy metabolism in organ tissues, and to explore the significance of this dependency as to evaluate tissue oxygenation. Methods: The model of septic shock was established by cecum ligation and puncture(CLP). SD rats were randomized to 7 groups: pre-CLP, 2, 4, 5, 6, 7 and 8h after CLP. The parameters of oxygen kinetics were measured just before rats were killed. Liver, heart and kidney tissues were removed quickly and tissue phosphocreatine (PC) and adenosine triphosphate (ATP) were assayed using the luciferase enzyme system. Results： Biphasic relationship between systemic oxygen delivery (DO2) and oxygen consumption (VO2) was exhibited. DO2 decreased progressively and lowered to a value of critical DO2 (cDO2) at 6 h after CLP. Pathologic supply dependency of VO2 on DO2 existed below cDO2. At 5 h after CLP, PC levels were lowered (P＜0.05) in liver tissues. Reductions both in hepatic ATP and renal PC and ATP levels were present. Myocardial PC and ATP levels decreased significantly (P＜0.01) at 6 and 7 h after CLP, respectively. Conclusion： The existence of pathologic dependency of VO2 on DO2 was indicative of the defect of energey metabolism. That abnormalities in renal and hepatic tissues began to exist before cDO2 appeared. Further management to prevent cellular bioenergetic failure should be taken in early septic shock. |
| Key words: oxygen delivery oxygen consumption shock,septic |
