脂氧素A_4对兔心脏骤停后综合征中心肌结构和功能的影响  

Effects of Lipoxin A_4 on the Structure and Function of Myocardium in the Post-Cardiac Arrest Syndrome of Rabbits

作　　者：陈志桥[1] 赵剡[1] 周奕融[1] 石慧娟[1] 刘耕[1] 

机构地区：[1]武汉大学中南医院急救中心,湖北武汉430071

出　　处：《武汉大学学报（医学版）》2011年第6期739-743,I0002,共6页Medical Journal of Wuhan University

摘　　要：目的:探讨脂氧素A4对新西兰兔心脏骤停心肺复苏(CPR)后血流动力学、心肌坏死面积、心肌细胞结构(光镜和电镜)、血清心肌酶水平的影响。方法:健康新西兰大白兔16只,雌雄不限,随机分为空白组(假手术组)(n=4)、对照组(CPR+乙醇组)(n=6)和实验组(CPR+脂氧素组)(n=6)。所有实验动物耳缘静脉麻醉,气管切开行气管插管,左侧颈总动脉、右颈内静脉及股动脉置管。对照组和实验组动物,夹闭气管插管5-9min后引起动物窒息,诱导心脏骤停3min后,开始胸外按压,机械通气(纯氧),静脉注射200μg/kg的肾上腺素,同时实验组静脉给予脂氧素A4(1.5μg/kg)乙醇溶液,对照组给予等体积的2%乙醇溶液。监测自主循环恢复(ROSC)4h的血流动力学指标,于ROSC后6h股动脉取血检测肌酸激酶同工酶(CK-MB),然后处死取心脏标本,测量心肌坏死面积,检测光镜HE染色、电镜下心肌结构变化,观察脂氧素对上述指标的影响。结果:对照组和实验组复苏后反映心室收缩功能和舒张功能的dp/dtmax、-dp/dtmax以及平均动脉压均显著低于复苏前(P<0.01),但实验组复苏后的收缩、舒张功能和平均动脉压的改善要明显优于对照组(P<0.01);实验组较对照组血清CK-MB值显著降低(P<0.01),左心室坏死范围减小(P<0.05),心光镜和电镜下显示心肌结构损伤减轻,未见炎性细胞浸润。结论:脂氧素A4可抑制心肌内炎症反应,减轻心脏骤停兔心肺复苏后的心肌结构损害,同时改善心室收缩、舒张功能和血压,从而改善心功能不全。Objective： To investigate the effect of Lipoxin A4 on the changes of hemodynamics,areas of myocardial necrosis,myocardial structure,and levels of serum enzymes after resuscitation from cardiac arrest in New Zealand rabbits.Methods： Sixteen New Zealand rabbits were randomly divided into Sham group（n=4）,Ethanol group/control group（n=6）,and Lipoxin group/experimental group（n=6）.All experimental animals underwent anesthesia via auricular vein,performed tracheostomy,and catheterized the right carotid artery,right internal jugular vein and femoral artery.Both control and experimental groups had their tracheal tubes clamped for 5-9 min to induce asphyxia.Cardiopulmonary resuscitation（CPR） was started 3 min after the time of cardiac arrest;these animals were then ventilated with pure oxygen and injected with 200 μg/kg of adrenaline through the vein.In addition,the experimental group received injection of 1.5 μg/kg Lipoxin A4 ethanol solution,while the same volume of 2% ethanol solution were given to the control group.Hemodynamic parameters were monitored for four hours since the restoration of spontaneous circulation（ROSC）.Six hours after ROSC,serum creatine kinase-MB（CK-MB） was detected from the arteria cruralis.Then the myocardial samples were collected,and necrotic area was measured under light and electron microscopes.Results： Both Ethanol and Lipoxin groups had significantly lower dp/dtmax and-dp/dtmax of left ventricular pressure and mean arterial pressure（MAP） than those before CPR（P0.01）.However,the improvement of diastolic function in Lipoxin group were much more obvious（P0.01）,and the value of serum CK-MB was significantly lower in Lipoxin group than in Ethanol group（P0.01）.The necrotic area of the left ventricular was smaller（P0.01）.Damage to the myocardium structure has been reduced（P0.01）,and no inflammatory cells infiltration was found in Lipoxin group.Conclusion： Lipoxin A4 probably inhibits the inflammatory reaction in myocardium,and reduces damage

关 键 词：脂氧素 心脏骤停 心肌结构 心肌功能 

分 类 号：R459.7[医药卫生—急诊医学]