【摘要】 目的 :研究心肺复苏后大鼠肺组织细胞的损伤及其可能的影响因素。 方法 :选择健康 SD雄性大鼠 16只 ,随机均分为对照组和复苏组 ,采用琥珀酰胆碱 (0 .15 mg/ 10 0 g)窒息合并冰氯化钾 (0 .5 mol/ L,0 .12 ml/ 10 0 g,4℃ )致大鼠心跳骤停 ,停跳 5 min后开始心肺复苏 ,制备大鼠呼吸心跳骤停 -心肺复苏模型。复苏后 3h取动脉血行血气分析 ,取静脉血离心采用放射免疫法测定血清中 TNF- α含量 ,取肺组织测定湿干质量比值 (W/ D)、髓过氧化酶 (MPO)活性和丙二醛 (MDA)含量 ,通过光镜和电镜观察肺组织细胞结构的变化。 结果 :心肺复苏后 3h较对照组大鼠肺 W/ D值明显升高 (P<0 .0 5 ) ,Pa O2 降低 ,血清中 TNF- α含量、肺组织 MDA含量和 MPO活性明显升高 (P<0 .0 5 ) ,光镜、电镜观察结果显示肺组织细胞结构均有较明显受损的征象。结论 :心肺复苏后早期大鼠存在肺组织细胞损伤 ,肺功能受损 ,血清 TNF-α升高 ,氧自由基生成增多 ,中性粒细胞(PMN)在肺组织聚集可能参与了复苏后肺组织细胞损伤的过程。更多还原

【Abstract】 Objective:To investigate the mechanism of lung injury after cardiopulmonary resuscitation(CPR) in rats. Methods: Cardiac arrest was induced by asphyxiation(succinylcholine) and ice-cold 0.5 mol/L KCl in rats and CPR was carried out 5 min after arrest. Sixteen adult male Sprague-Dawley rats were randomly allocated into 2 groups:control group(n=8) and CPR group(n=8). The blood gas analysis,serum level of tumor necrosis factor α(TNF-α),lung tissue wet mass/dry mass ratio(W/D),lung malondialde-hyde(MDA) content and myeloperoxidase(MPO) activities were measured 3 h after CPR. The histological appearances of the lungs were observed under light and electron microscope. Results: Compared to the control group,the lung W/D,serum TNF-α,pulmonary MDA and MPO activity increased dramatically in CPR group while PaO 2 decreased 3 h after resuscitation(P<0.05). Histological examination demonstrated the injuries of lung tissues and the changes of the ultrastructure after resuscitation. Conclusion: Although pulmonary dysfunction is not serious,there are pulmonary pathological and ultrastructure damages in the earlier period after CPR. The elevation of TNF-α in systemic circulation,increase of oxygen-derived free radicals and accumulation of pulmonary PMN may play important roles in pulmonary damage after CPR.更多还原