阿托品对家兔缺氧性心动过缓加速心跳停止的作用  

Atropine treatment of hypoxic bradycardia accelerated the occurrence of cardiac arrest

作　　者：钱璐璐[1] 杜彬[1] 左云霞[1] 

机构地区：[1]四川大学华西医院麻醉科,成都610041

出　　处：《中华医学杂志》2012年第15期1070-1073,共4页National Medical Journal of China

摘　　要：目的观察阿托品在急性缺氧所致的进行性心动过缓抢救中对心跳停止发生的时间及复苏成功率的影响。方法64只新西兰大白兔数字随机分为两组：即刻复苏组（T1）和缺氧8min复苏组（T2）。T1组：呼气末夹闭气管导管诱发缺氧，心动过缓发生时随机给予阿托品50μg/kg或生理盐水，继续观察至心跳停止发生即刻开始复苏。他组：呼气末夹闭气管导管，同样在心动过缓发生时随机给予阿托品50μg/kg蝇或生理盐水，至缺氧8min时，开始复苏。观察实验动物的心率血压变化和心跳停止发生的时间。结果从开始缺氧到出现心跳停止发生的时间，阿托品治疗组（T1a组和T2a组）较生理盐水对照组（T1c组和T2c组）明显提前（P〈0．05）。与生理盐水对照组相比，在给药后的1．5min内阿托品组心率高于生理盐水对照组，随后这种差异消失。阿托品治疗组的血压在整个缺氧过程中明显降低。阿托品治疗组与生理盐水对照组比较心肺复苏成功率差异无统计学意义。结论在急性缺氧导致的进行性心动过缓的抢救过程中，若缺氧不能得到纠正，使用阿托品只能使心率短暂回升，而血压则降低更明显，心跳停止提前出现，且不能提高心跳停止后的复苏成功率。Objective To explore the therapeutic effects of atropine for hypoxic bradycardia during the occurrence of cardiac arrest. Methods Sixty-four adult New Zealand rabbits were selected and allocated randomly into 2 groups： instant resuscitation group and 8-minute resuscitation group. Each animal was anesthetized by an intravenous injection of sodium pentobarhital and intubated through treacheostomy. The racheostomy tube was then clamped off to induce acute hypoxia. At soon as heart rate （HR） decreased to a half of basic-heart-rate, either atropine 50 μg/kg or 0.9% normal saline as control was randomly administered intravenously. In instant resuscitation group （ group T1 ） , the tracheostomy tube was unclamped and cardiopulmonary resuscitation （CPR） initiated for the occurrence of cardiac arrest （ MAP 〈 10 mm Hg）. In 8-minute resuscitation group （ group T2 ） , the tracheostomy tube was clamped for 8 minutes and then CPR initiated. The statistical data were analyzed by SPSS 10. 0. All data were reported as x - s. T test was used to compare the means of cardiac arrest time between two groups, one-way ANONA to compare HR ＆ mean arterial pressure （MAP） and Fisher＇s exact probabilities test to compare the survival rates between two groups. A value of P 〈 0. 05 was considered statistically significant. Results The heart rate of atropine treated group was higher than that of normal saline group for about 90 minutes post-dosing. In atropine group, the MAP decrease was significantly faster than that of normal saline group （ P 〈 0. 01 ） . Most importantly, after the clamping of tracheostomy tube, the average time of cardiac arrest occurred at （335.43±43.25） s in atropine group versus （371 ± 55） s in normal saline group （P=0.006）. Conclusion Although atropine treatment of severe hypoxic bradycardia improves the decrease of HR for a short time, it decreases MAP and accelerates the occurrence of cardiac arrest result from acute hypoxia. But the mortality rate is not improved b

关 键 词：阿托品 心动过缓 缺氧 心肺复苏术 

分 类 号：R541.7[医药卫生—心血管疾病]