暴发性内毒素休克时家兔心功能的变化。

Z Velkov
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摘要

人类感染性休克通常以左心室功能的严重改变为特征,而对右心室功能障碍知之甚少。在兔双心室插管后,以2 mg/kg的剂量在脑室内注射大肠杆菌内毒素,测量其压力,并测定一些收缩指数。在内毒素休克发展非常迅速,并在60分钟至90分钟之间死亡的动物(休克发展称为暴发性)中,我们确定了两个心室功能的显著变化。20 min时,室内压、EDP、P-(dP/dtmax)升高,提示右心室张力导联。同时,正dP/dtmax、负dP/dtmax、(dP/dtmax)/P和[(dP/dt)/P]max降低,认为是右心室心肌收缩性和舒张性受损的证据。在随后的观察期,部分收缩指数恢复正常。第20分钟,左心室血压P-(dP/dtmax)、+ dP/dtmax、- dP/dtmax和(dP/dt)P下降。实验第30分钟至实验结束时出现明显的心动过缓。暴发性内毒素休克是兔右心室功能受损的结果,右心室功能受损归因于紧张导联和内毒素诱导的双心室心肌功能障碍。
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Changes in rabbit cardiac function during fulminant endotoxin shock.

Septic shock in humans is usually characterized by severe changes in the left ventricular function, while little is known about the dysfunction of the right ventricle. Rabbits were injected intraventricularly with endotoxin from Escherichia coli at a dose of 2 mg/kg following catheterization of both heart ventricles with the purpose of measuring their pressure, and determining a number of contractility indices. In the animals in which endotoxin shock developed very rapidly and death occurred between the 60th and the 90th min (shock development is called fulminant), we established significant changes in the function of both ventricles. At the 20th min, the intraventricular pressure, EDP and P-(dP/dtmax) increased, indicating a tension lead of the right ventricle. At the same time, there was a decrease in plus dP/dtmax, minus dP/dtmax, (dP/dtmax)/P and [(dP/dt)/P]max, considered evidence for impaired contractility and relaxation of the right ventricular myocardium. During the subsequent observation periods, some of the contractility indices returned to normal. At the 20th min, a reduction of intraventricular pressure, P-(dP/dtmax), plus dP/dtmax, minus dP/dtmax and (dP/dt)P was registered in the left ventricle. Pronounced bradycardia was observed from the 30th min to the end of the experiments. Fulminant endotoxin shock in rabbits occurs as a result of the impaired function of the right ventricle attributed to tension leading and endotoxin-induced biventricular myocardial dysfunction.

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