梭曼中毒进行性循环衰竭时重要生命体征的变化

摘要

Objective To investigate the changes of vital signs and the damage of important organs in dog progressive circulatory failures induced by soman.Method Seven male dogs,weighing(12～15)kg,were injected intramuscularly 1/3 LD sornan(1 LD=10μg/kg)per ten minutes.The moan blood pressure decreased to (40～45)mmHg was defined as circulatory failure.The changes of heart rate,blood pressure.and hemodynamic parameters were evaluated by an eight-channel direct-witing oscillograph,blood gas,pH value,electrolyte,and the damage of important organs were observed before and after sornan injection.Statistical analysis of the data was performed using the self control t test with the SAS 6.12 Software Program.Results In anesthetized dogs intoxicated with sornan,the circulatory failure was characterized by the significant decreases in blood pressure,heart rate and hemodymrnic parameters(P<0.05).Partial pressure of oxygen was less than 60 mmHg,saturation of oxygen Was less than 90% and partial pressure of carbon dioxide was greater than 50 mmHg in arterial blood of the dog model.These results showed mix respiratory failure occurred during intermittent positive pressure.Significant metabolic acidosis was induced by soman[pH(7.345±0.064)vs.(6.956±0.022),P<0.01].The concentralion of sodium ion and chloride ion in blood were changed gently.The concentrations of GTP,GOT,Cr,BUN,CK-MB and LDH were increased significantly(P<0.05),which showed multiple important organs including liver,kidney and heart were damaged by sornan.Conclusions The severe progressive circulatory failure induced by cholinesterase inhibitor sornan leads to the darnage of vital signs and important organs significantly.%目的 研究梭曼中毒导致进行性循环衰竭条件下,犬心率、血压、心脏功能、呼吸功能、血液酸碱平衡、血电解质等生命体征的变化以及重要器官的损伤情况.方法 杂种犬7只,雄性,体质量(12～15)kg.梭曼累积染毒,方法为每次肌肉注射1/3致死剂量(LD)梭曼(1 LD=10 μg/kg),每10 min追加1次;以平均动脉压降至(40～45)mmHg为循环哀竭标准.八导生理记录仪检测梭曼染毒前后的心率、血压、血流动力学参数,股动脉取血检测血气和pH值,股静脉取血检测电解质浓度和反映各重要器官损伤的指标.以梭曼染毒前各指标为对照组,染毒后实验结果用SAS 6.12软件进行自身对照t检验分析.结果 梭曼染毒导致麻醉犬循环哀竭发生后,心率、血压和血流动力学参数都被显著抑制(P<0.05).动脉血氧分压低于60 mmHg,血氧饱和度低于90%;即使在正压人工呼吸状态下,血二氧化碳分压依然高于50 mmHg,仍发生呼吸衰竭.犬血液pH值由染毒前的(7.345±0.064)降低到染毒后的(6.956±0.022),发生了明显的代谢性酸中毒(P<0.01).血电解质钠离子浓度和氯离子浓度仅有轻度变化.血液中GTP、COT、Cr、BUN、CK-MB和LDH在染毒后都有显著增加(P<0.05).结论 胆碱酯酶抑制剂类毒物梭曼中毒可引起机体出现严重的进行性循环衰竭,同时导致各种重要生命体征和重要器官发牛显著损伤.