磷酸肌酸对大鼠心肺复苏后脑能量代谢的影响  

Effects of exogenous phosphocreatine on brain energy metabolism of rats after cardiopulmonary resuscitation

作　　者：杨婷[1] 乔江华[2] 李冬芳[2] 何爱文[2] 陈寿权[1,2] 李章平[2] 李惠萍[2] 黄唯佳[2] 程俊彦[2] 

机构地区：[1]温州医学院附属第二医院急诊科,浙江省温州325000 [2]温州医学院附属第一医院急诊科

出　　处：《中华急诊医学杂志》2012年第3期265-270,共6页Chinese Journal of Emergency Medicine

基　　金：温州市科技计划项目（Y20080084）;温州医学院科研基金（HX2008015）

摘　　要：目的观察外源性磷酸肌酸（CP）对大鼠心肺复苏（CPR）后脑损伤的影响。方法成年雄性SD大鼠160只，随机（随机数字法）分为4组：假手术对照组（A组）、常规复苏组（B组）、小剂量CP组（C组）、大剂量CP组（D组），各组再分别按自主循环恢复（ROSC）后（B、C、D组）或气管切开后（A组）0．5、3、6、12、24h时间点分为5亚组（n=8）。B、C、D组采用窒息法建立大鼠CPR模型，ROSC后即刻C组静注CP0．5g/kg，D组静注CP1．0g／kg。A组仅施行麻醉、气管切开、血管穿刺等操作，不行窒息及复苏。各亚组在相应时间点取材大脑额叶。采用高效液相色谱法（HPLC）测定脑组织三磷酸腺苷（ATP）、二磷酸腺苷（ADP）、一磷酸腺苷（AMP）含量，并计算总腺苷酸（TAN）及能荷（EC）值；采用吸光度法测定脑组织Na^＋-K^＋-ATP酶、Ca^2＋-Mg^2＋-ATP酶活性；HE染色观察光镜下大脑皮层病理变化。应用SPSS16．0软件包进行数据统计，组间比较采用方差分析。结果与A组比较，B组c组各时间点ATP、TAN、EC、Na^＋-K^＋-ATPase、Ca^2＋-Mg^2＋-ATPase均降低（P〈0．05或P〈0．01），D组0．5、3、6、12h时间点的ATP、TAN、EC、Na^＋-K^＋ ATPase、Ca^2＋-Mg^2＋-ATPase均降低（P〈0．05或P〈0．01），B组各时间点AMP均升高（P〈0．01），C组D组0．5h和3h时间点的AMP升高（P〈0．01）；与B组比较，C组D组6、12、24h时间点的ATP、TAN、EC、Na^＋-K^＋-ATP酶、Ca^2＋-Mg^2＋-ATP酶均升高（P〈0．05或P〈0．01），C组D组6、12、24h时间点的AMP均降低（P〈0．05或P〈0．01）；与C组比较，D组6、12、24h时间点的TAN、Na^＋-K^＋-ATPase、Ca^2＋-Mg^2＋-ATPase以及24h的ATP均升高（P〈0．05或P〈0．01）。大脑皮层病理变化B组严重，C组D组较轻。结论心肺复苏后存在脑能量代谢障碍，CP可以增加CPR后脑组织中的ATP含量，提高Na^＋-K^＋-ATPase和Ca^2＋-Mg^2＋Objective To study the effects of exogenous phosphocreatine （CP） on brain injury after cardiopulmonary resuscitation （CPR） in rats. Methods A total of 160 male adult SD rats were randomly （random number） divided into 4 groups ： sham-operation control group （group A） , CPR group （group B） , low-dose CP group （group C ） , high-dose CP group （group D）, and each group was further divided into 5 subgroups （n = 8） as per study at different intervals, 0. 5, 3, 6, 12 and 24 h after restoration of spontaneous circulation （ROSC） in groups B, C and D or after traeheotomy in group A. Cardiac arrest （CA） was induced by using asphyxia to establish CPR model in group B, C and D. The CP 0. 5 g/kg used in group C or CP 1.0 g/kg used in group D was injected into femoral vein at beginning of ROSC. Rats in each subgroup were sacrificed and the tissues of frontal lobe of brain of rats were taken at different intervals.The levels of adenosine triphosphate （ATP）, adenosine diphosphate （ADP） and adenosine monophosphate （AMP） in cerebral cortex were measured by high performance liquid chromatography （HPLC）, and values of total adenine nueleotides （ TAN ） and energy charge （ EC ） were detected. The activities of Na ^＋ -K^＋ - ATPase and Ca^2＋ -Mg^2＋ -ATPase in cerebral cortex were assayed by speetrophotometrie method. The pathological changes of cerebral cortex were observed under optical microscope. The experimental data were processed with analysis of variance by using SPSS 16. 0 package. Results Compared with group A, the levels of ATP, TAN, EC, Na^＋ -K^＋ -ATPase, Ca^2＋ -Mg^2＋ -ATPase were lower （P 〈 0.05 or P 〈 0. 01 ） at each interval in groups B and C, and at intervals of 0. 5, 3, 6, 12 h in group D, and the levels of AMP were higher （ P 〈 0. 01 ） at each interval in group B and at intervals of 0. 5 h and 3 h in groups C and D. Compared with group B, the levels of ATP, TAN, EC, Na ^＋-K^＋ -ATPase, Ca^2 ＋ -Mg^2＋ -ATPase were higher �

关 键 词：心肺复苏 磷酸肌酸 能量 ATP ATP酶 脑损伤 大鼠 

分 类 号：R965[医药卫生—药理学]