α-甲基去甲肾上腺素对家兔心肺复苏后早期肌钙蛋白T及心肌组织形态学影响的实验研究  

Effects of α - methylnorepinephrine on Troponin T and myocardium at early stage of postresuscitation in rabbits

作　　者：杨小华[1] 冯友繁[1] 李培杰[1] 李惠萍[1] 张谦[1] 

机构地区：[1]兰州大学第二医院麻醉科,730000

出　　处：《中国急救医学》2009年第7期619-622,675,共5页Chinese Journal of Critical Care Medicine

基　　金：基金项目：甘肃省自然科学基金项目（No.0710RJZA036）

摘　　要：目的 通过观察心肺复苏后家兔肌钙蛋白T（cTnT）及心肌组织形态学的变化，明确选择性α2-肾上腺素能受体激动剂仪-甲基去甲肾上腺素（α-MNE）对复苏后心肌损伤的保护作用。方法18只清洁级家兔随机分为三组，A组：手术对照组，仅行麻醉、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（30μg/kg）；C组：α—MNE组，在复苏时使用α-MNE（100μg／kg）。在致颤前15mim，复苏后30、60、120、180及240min采血检测心肌损伤标识物eTnT，复苏后240min处死家兔取心肌组织进行光镜检查。结果①复苏成功后B、C组各时间段cTnT值均明显高于A组（P〈0．05），但C组升高幅度明显小于B组（P〈0．05），尤以60min时最显著（P〈0．01）；②B、C组光镜下均见心肌损伤，但C组心肌损伤较B组明显减轻。结论α-MNE可减少心肺复苏后早期CT胛释放，减轻心肌病理损伤，对复苏后缺血／再灌注损伤心肌有保护作用。Objective To observe the effects of selective α2 - adrenergic receptor agonist alpha - Methylnorepinephrine （α - MNE ） on Troponin T（ cTnT） and myocardium in the rabbit cardiopulmonary resuscitation. Methods 18 rabbits were randomly divided into three groups, A group： operation -control group, for anesthesia, surgery,and endotracheal intubation, but does not induced ventricular fibrillation; B group： epinephrine group, administration of the standard dose of epinephrine （ 30μg/kg ） during CPR; C group： α - MNE group, administration of α - MNE （ 100 μg/kg） during CPR. Collecting blood samples at certain time points to measure the concnrtration of cTnT. At 240th minute after successful resuscitation, take myocardium to do light microscopy detection. Results ①Compared with group A, the cTnT of the remaining two groups increased respectively （ P respectively 〈 0. 05）, increase of cTnT in group C were less than in group B （ P 〈 0. 05 ） at the same stage, especially at 60th minutes （P 〈 0. 01 ）. ②B, C group were seen myocardial injury under a light microscope, but the group C myocardial damage lighter than the group B. Conclusion The study has shown that α - methylnorepinephrine can have a protective effet on postresuseitation myocardial ischemia/reperfusion injury in rabbits.

关 键 词：心肺复苏 Α2-肾上腺素能受体激动剂 心功能不全 

分 类 号：R605.974[医药卫生—急诊医学]