目的观察失血复合氰化物中毒对大鼠脑血氧和能量代谢的影响。方法实验动物随机分为假手术组、失血性休克组、氰化钾中毒组和失血性休克复合氰化钾中毒组,观察各组大鼠脑静脉血氧饱和度(jugular venous O2saturation,SjvO2)的改变,采用高效液相色谱测定大脑皮层ATP、ADP和AMP含量,分光光度法检测大脑皮层ATP酶活性的变化。结果与氰化钾中毒组比较,休克复合氰化钾中毒组大鼠SjvO2下降程度更为严重,且恢复速度减慢;脑ATP含量在复合损伤60 min和120 min时降低,差异有统计学意义,ADP、AMP含量则明显升高;脑Na+-K+-ATPase和Ca2+-ATPase活性变化趋势与单纯中毒组一致,但在复合损伤60 min和120 min时活性低于氰化钾中毒组,差异有统计学意义。结论失血条件下氰类化合物中毒可进一步加重脑血氧和能量代谢障碍。 Objective To observe the effects of blood loss combined with cyanide poisoning on cerebral blood oxygenation and energy metabolism in rats. Methods Experimental animals were randomly divided into sham operation group, hemorrhagic shock group, potassium cyanide poisoning group and hemorrhagic shock combined with potassium cyanide poisoning group. The cerebral venous oxygen saturation (SjvO2) in each group was observed The content of ATP, ADP and AMP in cerebral cortex were determined by HPLC. The changes of ATPase activity in cerebral cortex were detected by spectrophotometry. Results Compared with potassium cyanide poisoning group, SjvO2 decreased more severely and recovered slowly in shock-treated KCNP rats; ATP content decreased at 60 min and 120 min after compound injury, the difference was statistically significant , While the levels of ADP and AMP were significantly increased. The changes of Na + -K + -ATPase and Ca2 + -ATPase activities in the brain were the same as those in the simple poisoning group, but the activities were lower in the 60min and 120min composite injury than those in the potassium cyanide poisoning group Statistical significance. Conclusion Cyanide poisoning under the conditions of blood loss may further aggravate cerebral blood oxygen and energy metabolism disorders.