加压素与肾上腺素在小鼠心肺复苏中的疗效比较  

Comparison of the efficacy of vasopressin and epinephrine during cardiopuimonary resuscitation in mouse model

作　　者：宋凤卿[1] 陈蒙华[1] 谢露[2] 田晓芬[1] 

机构地区：[1]广西医科大学第一附属医院心血管病研究所,南宁530027 [2]广西医科大学基础医学院生理学教研室

出　　处：《中华急诊医学杂志》2009年第4期392-396,共5页Chinese Journal of Emergency Medicine

基　　金：基金项目：广西自然科学基金资助项目（0718007B-41）;广西研究生创新教育计划资助项目（2008105981002D25）;广西大型仪器网测试经费资助（779-2008-192;549-2007-128;542-2007-121）

摘　　要：目的比较加压素与肾上腺素在小鼠心肺复苏中的疗效。方法30只雄性昆明小鼠经食道快速起搏心室诱发室颤、建立心搏骤停模型，起搏开始后4min将小鼠随机分成3组（n=10／组）：对照组（Sal—gro）、加压素组（Vas-gro）、肾上腺素组（Epi—gro），分别经动脉注射药物（生理盐水、加压素0．4U／kg和肾上腺素0．04mg／kg）1次，开始胸外心脏按压及机械通气，观察自主循环恢复情况，10min无效则放弃复苏。自主循环恢复的小鼠连续监测心电和血压60min，观察血压、心率、呼吸恢复情况及生存时间。结果加压素与肾上腺素组小鼠的自主循环恢复率均显著高于对照组（9／10，10／10和3／10，P〈0．05，P〈0．01），加压素与肾上腺素组组间比较差异无统计学意义（P〉0．05）。肾上腺素组小鼠在自主循环恢复后全部出现自主呼吸，而加压素组小鼠只有4只出现自主呼吸（P〈0．05）。肾上腺素组小鼠的生存时间明显长于加压素组和对照组小鼠（P〈0．05，P〈0．05）。结论加压素和肾上腺素均可显著提高心搏骤停小鼠的自主循环恢复率，但0．04mg／kg的肾上腺素对自主循环恢复后小鼠呼吸功能及生存时间的影响明显优于0．4U／kg的加压素，其机制尚不清楚，还有待进一步研究。Objective To compare the effects between vasopressin and epinephrine during cardiopulmonary resuscitation （CPR） in a mouse model of cardiac arrest （CA）. Method Transoesophageal cardiac pacing was performed so as to elicit cardiac arrest in 30 Kunming male mice. Four minutes after the initiation of cardiac pac- ing, the animals were prospectively randomized into three groups in equal number （ n = 10/group）, namely, control group （ saline 0.2 mL intra-arterial）, vasopressin group （ vasopressin 0.4 U/kg intra-arterial） and epinephrine group （epinephrine 0.04 mg/kg intra-arterial）, then CPR was initiated. Restoration of spontaneous circulation （ROSC） was observed. If ROSC failed to appear at 10 minutes after CPR, resuscitation was discontinued. Electrocardiogram and blood pressure of resuscitated animals were invasively monitored for an additional 60 minutes. Electrocardiogram and blood pressure, and the restoration of spontaneous respiration and survival time were observed and recorded. Results Rates of ROSC in vasopressin group and epinephrine group were significantly higher than those in saline group （9/10,10/10 vs. 3/10, P 〈 0.05, P 〈 0.01 respectively）, and there was significant difference between vasopressin and epinephrine group. All resuscitated mice treated with epinephrine restored spontaneous respiration after ROSC, while only 4 of 9 animals treated with vasopressin did （ P 〈 0.05）. Survival time of ani- mals in epinephrine group was longer than that in vasopressin group or in saline group （ P 〈 0.05, P 〈 0.05, respectively）. Conclusions Both vasopressin and epinephrine increase the rates of ROSC. Epinephrine 0.04 mg/kg improved respiratory function and results in a longer survival time compared with vasopressin 0.4 U/kg in this mouse model, and the precise mechanism is not clear and further investigation is required.

关 键 词：心搏骤停 心肺复苏 加压素 肾上腺素 小鼠 

分 类 号：R459.7[医药卫生—急诊医学]