【摘要】 目的 探讨心肺复苏后大剂量糖皮质激素对脑单胺类神经递质及脑组织结构的影响。方法 21只健康杂种犬随机分为三组,常规复苏组(n=5),大剂量地塞米松组(n=8),大剂量甲基强的松龙组(n=8)。建立Pittsburgh标准室颤-心搏骤停(VF-CA)模型,复苏成功后大剂量地塞米松组和甲基强的松龙组分别经股静脉给予地塞米松5mg/kg和甲基强的松龙30mg/kg,各组动物于复苏后8h在麻醉状态下取右顶叶皮层组织三块,采用高效液相色谱-电化学法(HPLC-ECD)测定脑组织中单胺类神经递质5羟色胺(5-HT)、多巴胺(DA)的含量,显微镜和透射电镜观察其结构变化。结果 应用大剂量糖皮质激素后脑皮层组织中5-HT、DA的含量较常规复苏组明显下降(P<0.05),而大剂量地塞米松组和甲基强的松龙组间差异无显著性(P>0.05)。显微镜及透射电镜观察大剂量糖皮质激素组脑水肿和各细胞器的损害程度明显减轻,且甲基强的松龙组脑水肿减轻程度更为明显。结论 大剂量糖皮质激素具有确切的脑保护作用。更多还原

【Abstract】 Objective To examine if high-dose glucocorticoid has any cerebral protective effects aftercardiopulmonary resuscitation. Methods Twenty-one healthy mongrel dogs of both sexes weighing 10 .5-15 kg weresubjected to cerebral ischemia using Pittsburgh standard ventricular fibrillation-cardiac arrest （VF-CA） model. Theanimals were anesthetized with intraperitoneal pentobarbital sodium 30 mg·kg^-1 and mechanically ventilated thertracheal intubation (V_T 15 ml·kg^-1, RR 18-20 bpm). Right femoral vein was cannulated for fluid administration(lactated Ringer’s solution 0. 15 ml·kg^-1·min^-1) and right femoral artery was cannulated for BP monitoring. ECGwas continuously monitored. The animals were randomly divided into 3 groups: group A received only routineresuscitation treatment （control, n = 5）; group B received dexamethasone 5 mg·kg^-1 （n = 8） and group Cmethylprednisolone 30 mg·kg^-1 （n = 8） after successful cardiopulmonary resuscitation. 8 hours after resuscitationthe animals were anesthetized and three pieces of brain tissue were obtained from right parietal lobe for light andelectron microscopic examination and determination of dopamine （DA） and 5-hydroxy-tryptamine （5-HT） contentsusing high-performance liquid chromatography- electrochemical technique （HPLC- ECD ）. Results The DA and 5 -HT contents in parietal lobe of cortex were significantly decreased in group B and C as compared with group A （P<0 .05）. The degree of brain edema and damage to cell organelle were attenuated in group B and C. ConclusionHigh dose glucocorticoid has cerebral protective effects.更多还原