血管升压素对大鼠心肺复苏后早期心脏收缩功能的影响  

Effects of vasopressin on early cardiac systolic function in the rats after cardiopulmonary resuscitation

作　　者：刘海健[1] 张谦[1] 王建光[1] 翁浩[1] 徐振兴[1] 

机构地区：[1]上海市奉贤区中心医院(南方医科大学附属奉贤医院)麻醉科,201400

出　　处：《中国急救医学》2011年第9期822-826,共5页Chinese Journal of Critical Care Medicine

摘　　要：目的评价血管升压素（VAP）对大鼠心肺复苏（CPR）后早期心脏收缩功能的影响。方法健康12周龄sD大鼠36只，体质量（300±20）g，随机分为二三组，每组12只。A组（假手术组）：仪气管切开插管和右颈总动脉置管；E组（肾上腺素组）：窒息致心脏骤停（CA）后用肾上腺素每次0．02mg／kg进行CPR；V组（VAP组）：窒息致CA后用VAP每次0．8U／kg进行CPR，记录坶只大鼠窒息前（T0）及自主循环恢复（ROSC）后即刻（T1）、2h（T2）、4h（T3）HR、SBP、DBP、LVSP、＋LVdp／dt及动脉血气情况，每只大鼠CA时间、ROSC时间、ROSC率，每只大鼠T3时血清心肌肌钙蛋白T（cTnT）及脑钠素（BNP）水平．结果①与V组比较，E组ROSC时间长，而ROSC率低（P〈0．05）。②E、V组ROSC后各时刻HR、SBP、LVSP、＋LVdp／dt及E组ROSC后各时刻DBP较T0降低（P〈0．05）；与V组比较，E组T1时HR，T2、T33时SBP，T1、T2、T3时DBP、LVSP、＋LVdp／dt降低（P〈0．05）。③E组ROSC后各时刻pH、PO2、PCO2与T0比较差异有统计学意义（P〈0．05）；V组ROSC后各时刻PO2、PCO2与T1比较差异有统计学意义（P〈0．05）；与V组比较，E组T1时PCO：高，T2、T3时PO2低，T1、T2、T3时pH低（P〈0．05）。④二三组cTnT水平比较以及A组与E、V组BNP水平比较差异有统计学意义（P〈0．05）。结论VAP可以明显减轻大鼠心肺复苏后早期心脏收缩功能不全的程度。Objective To evaluate the effects of vasopressin on early cardiac systolic function of eardiopuhnonatT resuscitation （CPR） in rats. Methods Thirty -six healthy SD rats aged 12 weeks, weighting （300 _＋ 20） g were randomly divided into 3 groups （n = 12 each）. Group A （sham group） ： only intubation through the tracheal and the right carotid. Group E （epinephrine group）： CPR with epinephrine 0.02 mg/kg each time ＇after cardiac arrest （CA）. Group V （vasopressin group） ： CPR with vasopressin 0.8 U/kg each time after CA. HR, SBP, DBP, LVSP, ＋ LV dp/dt and arterial blood gases at time of basic（ TO ） , restoration of spontaneous circulation （ROSC） （ T1 ） , 2 hours （ T2 ） and 4 hours （T3）, time of CA and ROSC, ratio of ROSC, the level of cTnT and BNP at the time of T3 were all recorded. Results （1）Compared with group V, time of ROSC were longer and the ratio of ROSC were lower in group E（P 〈 0.05）. （2）Compared with To, HR, SBP, LVSP, ＋ LVdp/dt after ROSC in group E and group V, and DBP after ROSC in group E at different time points were lower （ P 〈 0.05）. Compared with group V, HR at T3, SBP at T2 and T3, DBP, LVSP, ＋LVdp/dt at T1,T2 and T3 in group E were all lower（ P 〈0.05 ）. （3）Compared with T0 in group E, there were significant diffbrences in pH, PO2 and PCO2 of different time points ＇after ROSC. Compared with To in group V, PO2 and PCO2 of different time points after ROSC were significantly different（ P 〈0.05）. Compared with group V, PCO2 at T1 was higher, PO2 at T2 and T3 was lower, and pH at T1 , T2 and T3 was lower in group E（ P 〈0. 05 ）. （4）There were significant differences in cTnT among three groups and the BNP between group A and the others. BNP in group E and group V had no significant differences （ P 〈 0.05 ）. Conclusion Vasopressin could decrease the level of systolic dysfunction in rats after CPR caused by asphyxia.

关 键 词：心肺复苏 心脏功能 肾上腺素 血管升压素 

分 类 号：R541.4[医药卫生—心血管疾病]