摘要
目的研究心脏骤停大鼠心肺复苏后血清及心肌氧自由基表达、左心功能的变化、心肌半定量评分及不同剂量血必净的干预。方法成功建立窒息大鼠心肺复苏模型96只，随机分为4组，每组24只。假手术组（s组）：无窒息及心肺复苏，仅予麻醉和气管切开插管；常规复苏组（C组）：常规复苏＋生理盐水4mL／kg；血必净低剂量组（LD组）：血必净2mL／kg＋生理盐水2mL／kg；血必净高剂量组（HD组）：血必净4mL／kg。分别测定：①每只大鼠术前及自主循环恢复（ROSC）后2、4、6h血清超氧化物歧化酶（SOD）、丙二醛（MDA）、左心室内压最大上升及下降速率（±LVdp／dtmax）；②心肺复苏术后6h心肌组织SOD、MDA表达及心肌半定量评分。结果①血清SOD：与S组及术前比较，C、LD、HD组在复苏后2h升高（P〈0．05）；复苏后6h，仅C、LD组下降（P〈0．05）。复苏后6h，HD组高于C、LD组（P〈0．05）。②血清MDA：与S组及术前比较，复苏后6h仅C、LD组升高（P〈0．05）。LD、HD组在复苏后6h低于C组，（P〈0．05）。③复苏后6h心肌SOD以HD组最高，C组最低（P〈0．05）。心肌MDA以C组最高，HD组最低（P〈0．05）。④4-LVdp／dtmax：与s组各观察点比较，C组下降（P〈0．05）。复苏后6hHD组最高，C组最低，（P〈0．05）。⑤4-LVdp／dtmax与心肌SOD呈正相关，与心肌MDA呈负相关（P〈0．05）。⑥左心室组织形态光镜下10倍目镜下半定量评分，C组明显高于LD、HD组（P〈0．05）。结论①在以窒息致心脏骤停的大鼠心肺复苏模型中，ROSC后血清SOD存在一过性升高；②心肺复苏术后存在明显血清及心肌中MDA增加、SOD下降，左心室收缩舒张功能不全；③血必净干预后血清及心肌MDA下降，SOD升高，左心室内压最大上升及下降速率升高，心肌病变好转，且存在量效关系。
Objective To investigate the changes of serum, myocardial oxygen free radicals and left ventricular function in cardiac arrest rats after cardio - pulmonary resuscitation and the therapeutic effect of Xuebijing. Methods 96 successful cardio - pulmonary resuscitation rats were randomly divided into 4 groups and each group contained 24 rats. Group S： no asphyxia or cardio - pulmonary resuscitation, only anesthetization and intubation tube in trachea; Group C： conventional recovery ＋ 4 ml/kg saline ; Group LD ： 2 mL/kg Xuebijing ＋ 2 mL/kg saline ; Group HD ： 4 ml/kg Xuebijing. Serum SOD, MDA, -＋ LVdp/dtmax before and after ROSC; SOD, MDA in heart tissue 6 h after cardio - pulmonary resuscitation were determined. Results （1）2 h after ROSC, serum SOD of each recovery group was increased compared to that in Group S （P 〈 0.05）. But 6 h after ROSC, only serum SOD in Group C and LD was decreased （ P 〈 0.05 ）. The levels of serum SOD 6 h after ROSC were ： Group HD 〉 LD 〉 C （P 〈 0.05 ）. （2）Serum MDA in Group C and Group LD 6 h after ROSC was higher thanthat in Group S （P 〈 0.05 ）. The levels of serum MDA 6 h after ROSC were ： Group C 〉 LD ~, HD （ P 〈 0.05）. （~5 h after resuscitation, Group HD showed the highest level of cardiac SOD and lowest level of cardiac MDA （P 〈 0.05 ）, while Group C showed the lowest level of cardiac SOD and highest MDA （P 〈0. 05）. （4） ＋ LVdp/dtmax in Group C after ROSC was lower than that in Group S and the status before ROSC （P 〈 0.05 ）. ＋ LVdp/dtmax 6 h after ROSC were ： Group HD 〉 LD 〉 C （ P 〈 0.05 ）. （5） ± LVdp/dtmax was positively correlated to cardiac SOD （ P 〈 0.05 ） but negatively correlated to cardiac MDA （P 〈 0.05）. （6）Semi - quantitative scores of the left ventricular morphology under light microscope were ： Group C 〉 S, LD, HD （P 〈 0.05）. Conclusion （1）Serum SOD shows a transient rise after successful cardiopulmonary resuscitation in asphyxia rat model. （2） After cardiopulmonary resuscitation, serum and cardiac SOD is decreased and MDA is increased; ± LVdp/dtmax is decreased which indicates a left ventricular systolic and diastolic dysfunction. （3）Xuebijing intervention reverses the changes of SOD and MDA, prevents the decrease of LVdp/dtmax and improves the myocardial histopathological changes in a dose - dependent manner.
出处
《中国急救医学》
CAS
CSCD
北大核心
2014年第3期255-258,共4页
Chinese Journal of Critical Care Medicine
基金
贵州省科技攻关项目（黔科合S字[2007]1055）
贵州省省长基金资助课题（黔省专合字（2007）66号）
关键词
窒息
心肺复苏
丙二醛
超氧化物歧化酶
左心功能
血必净
Asphyxia
Cardiopulmonary resuscitation
Malondialdehyde
Superoxide dismutase
Left ventricular function
Xuebijing
