CAJ | 학술논문

目的通过对血流动力学指标、心肌损伤标志物cTnT及心肌组织形态学观察,明确α-甲基去甲肾上腺素(α-MNE)是否町减轻复苏后心肌损伤、改善心脏功能.方法兰州市兽医研究所提供18只清洁级家兔,体质量2.5～3.5 kg,雌雄不拘,通过体外致颤法建立家兔心肺复苏模型.按数字随机法随机分为三组:A组手术对照组,仪行麻醉、手术、气管插管,但不致颤;B组:肾上腺素组,在复苏时使用标准剂量肾上腺素(30 μg/ks);C组:α-MNE组,在复苏时使用α-MNE(100 μg/kg).动态观察致颤前15 min、复苏后30 min,60 min,120 min,180 min,240 min左室舒张末压(LVEDP)、左室内压上升和下降最大速率(peak±dp/dt)及心肌损伤标志物cTnT变化,在复苏后240 min处死家兔取心肌组织进行光镜检查.统计学处理数据采用Spss 10.0软件处理,组间比较采用ANOVA方差分析.结果与A组比较,其余两组复苏成功后LVEDP明显升高(P<0.01),peak±dp/dt显著F降(P<0.01);C组与同时相B组比较,LVEDP升高幅度明显降低(P<0.05),peak ±dp/dt降低程度显著减轻(P<0.05);与A组比较,其余两组复苏成功后cTnF明显升高(P<0.01),但C组升高幅度明显小于B组(P<0.05).B、C组光镜下均见心肌损伤,但C组心肌损伤较B组轻.结论 α-甲基去甲肾上腺素可减轻复苏后心肌损伤、改善心脏功能,对复苏后心脏具有一定有保护作用.
목적 통과대혈류동역학지표、심기손상표지물cTnT급심기조직형태학관찰,명학α-갑기거갑신상선소(α-MNE)시부정감경복소후심기손상、개선심장공능.방법 란주시수의연구소제공18지청길급가토,체질량2.5～3.5 kg,자웅불구,통과체외치전법건립가토심폐복소모형.안수자수궤법수궤분위삼조:A조수술대조조,의행마취、수술、기관삽관,단불치전;B조:신상선소조,재복소시사용표준제량신상선소(30 μg/ks);C조:α-MNE조,재복소시사용α-MNE(100 μg/kg).동태관찰치전전15 min、복소후30 min,60 min,120 min,180 min,240 min좌실서장말압(LVEDP)、좌실내압상승화하강최대속솔(peak±dp/dt)급심기손상표지물cTnT변화,재복소후240 min처사가토취심기조직진행광경검사.통계학처리수거채용Spss 10.0연건처리,조간비교채용ANOVA방차분석.결과 여A조비교,기여량조복소성공후LVEDP명현승고(P<0.01),peak±dp/dt현저F강(P<0.01);C조여동시상B조비교,LVEDP승고폭도명현강저(P<0.05),peak ±dp/dt강저정도현저감경(P<0.05);여A조비교,기여량조복소성공후cTnF명현승고(P<0.01),단C조승고폭도명현소우B조(P<0.05).B、C조광경하균견심기손상,단C조심기손상교B조경.결론 α-갑기거갑신상선소가감경복소후심기손상、개선심장공능,대복소후심장구유일정유보호작용.
Objective To observe the effects of selective α2-adrenergic receptor agonist alpha-Methylnore-pinephrine(α-MNE) as a vasopressin agent on hemodynamics, troponin T(cTnT) and myocardium in the rabbit cardiopulmonary resuscitation. Method Eighteen health rabbits, weighing 2.5 - 3.5 kg, both male and female,were provided by Lanzhou institute of veterinary medicine. After setting up rabbit model of cardiopulmonary resuscitation, 18 rabbits were randomly divided into three groups. The rabbits in group A as a operation-control group were processed with anesthesia, endotracheal intubation, and surgery without ventricular fibrillation induced. The rabbits in group B as a epinephrine group were administered with 30 ug/kg epinephrineduring CPR. The rabbits in group C as a MNE group were administered with 100 ug/kg α-MNE during CPR. The left ventrictdar end-diastolic pressure(LVEDP), left ventricular pressure rise and fall rate(± dp/dt) and serum concentrations of BNP were measured. Statistic package of SPSS 10.0 was used for the data analysis and significant differences between means were evaluated by ANOVA analysis. Results Compared with group A, LVEDP of other two groups gradually increased respectively(P < 0. 01), and peak ± dp/dt decreased in other two groups(P<0.01). Increase in LVEDP in group C was less than that in group B(P<0.05), whereas peak ± dp/dt in group C were higher than that in group B(P<0.05), at the same stage. Compared with group A, the cTnT of the remaining two groups increased(P<0.01, respectively),and reached peak at 30 minutes. In group C, the elevation of cTnT was less than that in group B(P<0.05) during the same period. In group B and C, myocardial injury was seen under a light microscope, but the injury in group C was lighter than that in group B. Conclusion The methylnorepinephrine can lessen the myocardial dysfunction after CPR.