本文選題：高原 + 失血性休克��； 參考：《蘭州大學(xué)》2017年碩士論文

【摘要】：目的:探討高原環(huán)境下容量控制性失血性休克豬體內(nèi)丙泊酚藥代動(dòng)力學(xué)的特點(diǎn)。方法:24頭健康長(zhǎng)白豬,隨機(jī)分為4組,分別為休克組(HS組)、對(duì)照組(C組)、晶體液復(fù)蘇組(JR組)、膠體液復(fù)蘇組(HR組),每組6頭。HS組、JR組及HR組在20min內(nèi)由右側(cè)股動(dòng)脈放出總血量的30%血液,建立高原(海拔4120米)容量控制性失血性休克模型,穩(wěn)定30min后,HR組在30min內(nèi)輸入等失血量的羥乙基淀粉;JR組在30min內(nèi)輸入等失血量的復(fù)方氯化鈉;液體輸注結(jié)束后時(shí)間點(diǎn)四組均靜脈泵入丙泊酚150μg·Kg-1·min-1共10min。在開始泵注丙泊酚的1、2、3、4min,停止泵注丙泊酚時(shí),停止泵注丙泊酚后1、2、4、8、15、25、35、50、70、90、120、150和180min抽取動(dòng)脈血樣2ml,采用高效液相-紫外線法(UPLC-UV)測(cè)定丙泊酚血漿藥物濃度。根據(jù)測(cè)定的血藥濃度計(jì)算丙泊酚的消除半衰期(t1/2)、血漿-效應(yīng)室平衡速率常數(shù)(Ke0)、藥時(shí)曲線面積(AUC)及平均駐留時(shí)間(MRT)等藥代動(dòng)力學(xué)參數(shù)。結(jié)果:與C組相比,HS組和JR組各時(shí)間點(diǎn)丙泊酚血漿濃度高于C組(P0.05)。HR組丙泊酚血漿濃度在輸注開始1min、輸注結(jié)束4min和輸注結(jié)束25min有差異(P0.05),其余時(shí)間點(diǎn)無明顯差異(P0.05);HS和JR組Cmax顯著增高(P0.01),HR組Cmax無明顯差異(P0.05);HS組和JR組t1/2顯著延長(zhǎng)(P0.01),HR組無明顯變化(P0.05)。C組t1/2為39.91±5.52min,HS組t1/2為74.59±8.61min,較C組延長(zhǎng)約1.8倍。與C組相比,HS組和JR組Ke0顯著增大(P0.05),HR組無明顯差異(P0.05);HS組和JR組AUC顯著增大(P0.05),HR組略增大,但無統(tǒng)計(jì)學(xué)差異(P0.05);HS組和JR組MRT顯著延長(zhǎng)(P0.01),HR組無明顯差異(P0.05)。結(jié)論:在高原環(huán)境下容量控制性失血性休克豬體內(nèi)丙泊酚的藥代動(dòng)力學(xué)特點(diǎn)是其在體內(nèi)清除和排泄時(shí)間大大延長(zhǎng),血漿-效應(yīng)室平衡速率常數(shù)(Ke0)和藥時(shí)曲線面積(AUC)增大,藥物消除半衰期(t1/2)和體內(nèi)平均駐留時(shí)間(MRT)延長(zhǎng)。等量晶體液復(fù)蘇不足以改善低血容量情況,致使丙泊酚代謝減慢,血藥濃度增加,而等量膠體液可以逆轉(zhuǎn)丙泊酚代謝動(dòng)力學(xué)的改變。
[Abstract]:Objective: to investigate the pharmacokinetics of propofol in porcine with volume controlled hemorrhagic shock at high altitude.Methods 24 healthy Landrace pigs were randomly divided into 4 groups.They were shock group (HS group), control group (C group), lens fluid resuscitation group (JR group), colloid fluid resuscitation group (HR group). Each group (6 heads. HS group JR group and HR group) released 30% of the total blood volume from the right femoral artery in 20min.The model of volume controlled hemorrhagic shock at high altitude (4120 m above sea level) was established. After stabilizing 30min, the HR group was treated with 30min, and the hydroxyethyl starch JR group (JR group) was infused with compound sodium chloride with equal amount of blood loss in 30min.The intravenous infusion of propofol 150 渭 g Kg-1 min-1 for 10 mins was performed in the four groups at the time point after liquid infusion.The pharmacokinetic parameters of propofol such as elimination half-life of propofol (t ~ (1 / 2)), plasma-effect ventricular equilibrium rate constant (K _ (0)), drug time curve area (AUC) and mean residence time (MRT) were calculated according to the measured concentration of propofol.Conclusion: the pharmacokinetic characteristics of propofol in pigs with volume-controlled hemorrhagic shock at high altitude are that the clearance and excretion time of propofol in vivo is prolonged, the plasma-effect ventricular equilibrium rate constant (Ke0) and the area of drug time curve are increased.Drug elimination half life (t 1 / 2) and mean residence time (MRT) were prolonged.The resuscitation of the same amount of crystal fluid was not enough to improve the low blood volume, which resulted in the decrease of propofol metabolism and the increase of blood drug concentration, while the same amount of colloid solution could reverse the change of propofol metabolism kinetics.
【學(xué)位授予單位】：蘭州大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R614

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