CAJ | 학술논문

目的研究联用选择性α_2-肾七腺素能受体激动剂米伐西醇(mivazerol)和k-阿片受体激动剂U50488H对心肺复苏后兔血流动力学和B型利钠肽(B-type natriuretic peptide,BNP)的影响,探讨防治复苏后心功能不全的有效方法.方法于兰州大学医学院机能实验室,30只健康清洁家兔随机分为5组:肾上腺索组(E)、血管加压素组(V)、U50488H组(U)、米伐西醇组(M)、米伐两醇+U50488H组(M+U),建立心肺复苏模型(接通50 v交流电胸壁致颤),心肺复苏期间各组动物分别静注上述药物(自主循环恢复标准:恢复室上性心律,MAP≥60 mmHg持续5 min).于诱发室颤前15 min、复苏后30 min,60 min,120 min,180 min,240 min,动态监测血流动力学指标和心功能不全标志物BNP的浓度.统计学处理采用方差分析.结果 (1)M+U组复苏后MAP、peak-dp/dt、Peak+dp/dt各时间段值明显高于其余四组,LVEDP 上升幅度明显小于其余四组(均P<0.05).(2)复苏后,M+U组BNP各时间段浓度明显低于其余四组,与E,v,u组筹异具有统计学意义(P<0.01),与M组相比,差异具有统计学意义(P<0.05).结论联用米伐两醇和U50488H可改善复苏后血流动力学指标,减少复苏后早期BNP的分泌,改善复苏后心功能小全.
목적 연구련용선택성α_2-신칠선소능수체격동제미벌서순(mivazerol)화k-아편수체격동제U50488H대심폐복소후토혈류동역학화B형리납태(B-type natriuretic peptide,BNP)적영향,탐토방치복소후심공능불전적유효방법.방법 우란주대학의학원궤능실험실,30지건강청길가토수궤분위5조:신상선색조(E)、혈관가압소조(V)、U50488H조(U)、미벌서순조(M)、미벌량순+U50488H조(M+U),건립심폐복소모형(접통50 v교류전흉벽치전),심폐복소기간각조동물분별정주상술약물(자주순배회복표준:회복실상성심률,MAP≥60 mmHg지속5 min).우유발실전전15 min、복소후30 min,60 min,120 min,180 min,240 min,동태감측혈류동역학지표화심공능불전표지물BNP적농도.통계학처리채용방차분석.결과 (1)M+U조복소후MAP、peak-dp/dt、Peak+dp/dt각시간단치명현고우기여사조,LVEDP 상승폭도명현소우기여사조(균P<0.05).(2)복소후,M+U조BNP각시간단농도명현저우기여사조,여E,v,u조주이구유통계학의의(P<0.01),여M조상비,차이구유통계학의의(P<0.05).결론 련용미벌량순화U50488H가개선복소후혈류동역학지표,감소복소후조기BNP적분비,개선복소후심공능소전.
Objective To investigate the effects of α_2-adrenergic receptor agonist and k-opioid receptor agonist jointly used on hemodynamics and B-type natriuretic peptide in rabbits,and to explore the effective methods for lessensing post-resuscitation myocardial dysfunction.Method After the establishment of cardiopulmonary resuscitation (CPR) model in rabbits, 30 rabbits were randomly divided into 5 groups, namely epinephrine group(E), vasopressin group(V), U50488H group(U), mivazerol group(M) and mivazerol + U50488H group(M + U). Hemodynamics and B-type natriuretic peptide were examined before ventricular fibrillation and in the early stage of post CPR (30-240 min). Statistical analysis was performed with ANOVA techniques. Results (1)MAP,peak - dp/dt and peak + dp/dt in M + U group were significantly higher than those in other groups, and the increase of LVEDP was less than that in other groups (P<0.05).(2)The concentration of BNP in M + U group was significantly decreased than that in other groups (P <0.01 or P <0.05). Conclusions The α_2-adrenergic receptor agonist (mivazerol) and k-opioid receptor agonist used together can improve post CPR hemodynamics and reduce the concentration of B-type natriuretic peptide, lessening the post CPR myocardial dysfunction.