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目的研究胆碱酯酶抑制剂(ChEI)梭曼中毒导致犬发生进行性循环衰竭时酸中毒生化参数指标的变化及新型抗毒剂宾赛克嗪的干预作用。方法 14只杂种犬,雄性,体质量12～15 kg。随机分为循环衰竭组和呼吸衰竭组,每组7只。动物称重、麻醉后,进行气管插管,给予人工正压呼吸。将导管置入左心室、股动脉及股静脉,通过八导电生理记录仪,连续记录心功能及动脉压变化。开始梭曼累积染毒,方法为每次肌肉注射1/3 LD梭曼(1 LD=10μg/kg),每10 min追加1次。呼吸衰竭组以氧分压(PaO2)<60 mmHg,二氧化碳分压(PaCO2)>50mmHg、氧饱和度(SO2)<90%为标准,在犬达呼吸衰竭标准后,立刻用宾赛克嗪0.1 mg/kg肌肉注射进行抢救。循环衰竭组以平均动脉血压降至45 mmHg为标准,在循环衰竭维持约6 h后使用宾赛克嗪0.1 mg/kg静脉注射进行抢救。检测两组梭曼染毒前、后及抢救后动脉血指标变化。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。结果犬染毒1 h发生呼吸衰竭时,机体pH值由染毒前的7.290±0.040降低到7.150±0.050水平,PaCO2、PO2由染毒前的(42.6±3.6)和(92.0±6.4)mmHg改变为(56.1±6.5)和(38.4±9.3)mmHg,发生显著性差异(P<0.01),使用宾赛克嗪抢救6 h后,与呼吸衰竭酸中毒时相比pH值升高至7.290±0.110,恢复到染毒前水平,反映酸碱失衡的指标在2 h内均发生显著性改变(P<0.05)。犬染毒2 h发生循环衰竭时,pH值由染毒前的7.345±0.064降低到6.956±0.022,且呈显著性下降(P<0.01),使用宾赛克嗪救治后,平均动脉血压、pH值分别升高到76 mmHg、7.185±0.029水平(P<0.01,n=3～7),反映酸碱失衡的指标部分有显著性差异。结论 ChEI梭曼中毒诱发犬发生呼吸与循环衰竭时产生酸中毒,使用宾赛克嗪药物抢救后,在酸中毒的早期可得到明显改善作用,后期则能够有效地控制恶化的程度。
Objective To study the changes of biochemical parameters of acidosis and the effect of new antitoxic agent bezacazine when Soman cholinesterase (ChEI) induced progressive circulatory failure in dogs. Methods Fourteen mongrel dogs, male, weighing 12-15 kg. Randomly divided into circulation failure group and respiratory failure group, 7 in each group. Animals were weighed, anesthetized, endotracheally intubated, and given artificial positive pressure. The catheter was placed in the left ventricle, femoral artery and femoral vein through eight conductive physiology recorder, continuous recording of cardiac function and arterial pressure changes. Start Soman cumulative exposure by intramuscular injection of 1/3 LD soman (1 LD = 10μg / kg), an additional every 10 minutes. Respiratory failure group with the standard of oxygen (PaO2) <60 mmHg, PaCO2> 50mmHg, oxygen saturation (SO2) <90% mg / kg intramuscular injection for rescue. In the circulatory failure group, mean arterial blood pressure was reduced to 45 mmHg as the standard, and the patients were treated with intravenous infusion of 0.1 mg / kg bevacizumab for 6 hours after the maintenance of circulatory failure. The changes of arterial blood index before and after the soman administration and the rescue after the rescue were detected. To Soman before poisoning indicators for the control group, the experimental results after exposure to SAS 6.12 software for self-control t test analysis. Results When respiratory failure occurred in 1 h of canine infection, the pH of the body decreased from 7.290 ± 0.040 before exposure to 7.150 ± 0.050, while PaCO2 and PO2 were changed from 42.6 ± 3.6 and 92.0 ± 6.4 mmHg before exposure (56.1 ± 6.5) and (38.4 ± 9.3) mmHg, respectively (P <0.01). After being treated with bevacizine for 6 h, the pH value increased to 7.290 ± 0.110 when compared with respiratory failure acidosis , Returned to pre-exposure levels, the indicators of acid-base imbalance in 2 h were significantly changed (P <0.05). When the dogs were exposed to cyclic depletion for 2 hours, the pH value decreased from 7.345 ± 0.064 before exposure to 6.956 ± 0.022, and decreased significantly (P <0.01). The average arterial pressure, pH Values were increased to 76 mmHg and 7.185 ± 0.029, respectively (P <0.01, n = 3 ~ 7). There were significant differences in the indexes reflecting acid-base imbalance. Conclusions ChEI soman poisoning can cause acidosis in respiration and circulatory failure in dogs. After being treated with benthiazine, it can be obviously improved in the early stage of acidosis and can be effectively controlled in the later stage.