【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4 mL/kg;血必净低剂量组(LD组):血必净2 mL/kg+生理盐水2 mL/kg;血必净高剂量组(HD组):血必净4 mL/kg。分别测定:①每只大鼠术前及自主循环恢复(ROSC)后2、4、6 h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6 h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2 h升高(P<0.05);复苏后6 h,仅C、LD组下降(P<0.05)。复苏后6 h,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6 h仅C、LD组升高(P<0.05)。LD、HD组在复苏后6 h低于C组,(P<0.05)。③复苏后6 h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)。④±LVdp/dtmax:与s组各观察点比较,C组下降(P<0.05)。复苏后6 h HD组最高,C组最低,(P<0.05)。⑤±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。更多还原

【Abstract】 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 anesthetizafion and intubation tube in trachea;Group C:conventional recovery + 4ml/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-puhnonary resuscitation were determined.Results ①2 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).②Serum MDA in Group C and Group LD 6 h after ROSC was higher than that in Group S(P < 0.05).The levels of serum MDA 6 h after ROSC were:Group C > LD > HD(P <0.05).③6 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).⑥Semi- quantitative scores of the left ventricular morphology under light microscope were:Group C > S,LD,HD(P < 0.05).Conclusion ①Serum 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.③Xuebijing 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.更多还原