PDF《山莨菪碱对心肺复苏大鼠心脏结构和 心肌微血管血流量变化的...》

・ 论著・ 山莨 菪碱 对心 肺复 苏大 鼠心 脏结 构和 心肌 微血 管血 流量 变化 的影 响 贾立静 沈洪 陈威 计达 赵秀梅 刘秀华 【摘要】 目的 探讨山莨菪碱(Ani) 对心脏停搏大鼠心脏结构和心肌血流量变化的影响.

方法 采用电击致大鼠心脏停搏模型,将实验动物随机分为三组,每组

20 只. 心脏停搏后4 min行呼 吸机辅助呼吸、胸外心脏按压,4 min 后静脉给药,生理盐水对照组不用复苏药物;

肾上腺素组(Epi 组)静脉注射肾上腺素

200 μ g/ kg;

山莨菪碱组(Ani 组)静脉注射肾上腺素

200 μ g/ kg 并Ani

10 mg/ kg. 计算自主循环恢复率和复苏成功率;

测量左心室容积(LVV)和心室间隔厚度(VST);

利用激光多 普勒血流量图像仪测量心肌组织血流量. 结果 Ani组大鼠自主循环恢复率和复苏成功率(90%, 80%) >

Epi 组(75%,50%) >

对照组(50%,30%),三组相比有统计学差异(P <

0畅05). Ani 组LVV 的变化较 Epi 组轻;

Ani 组心肌组织血液灌注量在自主循环恢复(ROSC)后30 min、45 min、60 min 均 明显高于对照组和 Epi 组,差异有统计学意义(P <

0畅05). 结论 复苏早期应用 Ani 干预可望减轻 Epi 引起的负面影响,提高组织灌注量,从而改善复苏后的器官功能,可能会提高复苏的成功率. 【关键词】 心肺复苏术;

山莨菪碱;

肾上腺素 Effects of Anisodamine on myocardial structure and microvascular blood flow of the asystole rats during the cardiopulmonary resuscitation JIA Li唱jing,SHEN Hong,CHEN Wei,JI Da,ZHAO Xiu唱mei, LIU Xiu唱hua. Department of Emergency,Chinese PLA General Hospital,Beijing 100853,China Corresponding author:SHEN Hong,Email:shenhong@em120. com 【Abstract】 Objective To study the effects of anisodamine on myocardial structure and microvascular blood flow in Wistar rats during cardiopulmonary resuscitation . Methods

60 healthy Wistar rats subjected to cardiac arrest and resuscitation were randomly divided into normal saline group ( control group),epinephrine group (group Epi) and epinephrine plus anisodamine group (group Ani). After a

4 minutes non唱intervention interval,CPR started. After

4 minutes of CPR the animals in control group received normal saline,group Epi received epinephrine (bolus dose of

200 μ g/ kg),and Ani group epinephrine plus anisodamine (bolus dose of

200 μ g/ kg epinephrine followed by anisodamine of

10 mg/ kg). The changes of left ventricular volume(LVV),ventricular septal thickness (VST) and myocardium microvascular blood flow were observed. Results With the rate of ROSC and successful CPR :group Ani (90%,80%) >

group Epi (75%,50%) >

control group (50%,30%). The damage of LVV in group Ani was slighter than group Epi . The microvascular blood flow in group Ani was greater than group control and Epi from post 唱restoration of spontaneous circulation

30 min. Conclusions Anisodamine could ameliorate the side effects of epinephrine in CPR,improve myocardial perfusion and raise success rate of resuscitation . 【Key words】 Cardiopulmonary resuscitation ;

ANISODAMINE;

Epinephrine 肾上腺素是心肺复苏的一线应用药物,但近来有研究表明,大剂量的肾上腺素在增加心脏血流量、提高 冠状动脉灌注压的同时,可以降低心排血量,增加心肌氧耗,导致心肌收缩带的坏死,易引起复苏后的迟发 性心律失常,并可出现高肾上腺素能状态,从而对复苏产生不利影响 [1唱3] ,影响临床预后. 有研究表明,山莨 菪碱可以解除冠状动脉痉挛,增加冠状动脉血流量,改善心肌缺血和再灌注损伤,解除外周血管痉挛,减轻 DOI:10.