心肺复苏早期心肌的损伤及参附注射液的保护作用  

Shenfu injection attenuates the injury and dysfunction of myocardium in the early stage of cardiopulmonary resuscitation

作　　者：林志鸿[1] 蔺佩鸿[1] 郑建清[1] 康国强[1] 江勇[1] 

机构地区：[1]福建医科大学附属第一医院急诊科,福州350005

出　　处：《临床急诊杂志》2012年第3期183-185,共3页Journal of Clinical Emergency

基　　金：福建医科大学青年骨干教师课题(No:JGG200725)

摘　　要：目的:观察参附注射液对心搏骤停患者在心肺复苏早期的心肌保护作用,并探讨其作用机制。方法:将32例心搏骤停患者随机分成两组,除常规进行体外心肺复苏及给予复苏药物治疗外,治疗组在复苏开始后即应用参附注射液静脉注射,对照组仅给予等量的生理盐水。观察两组患者恢复有效自主心跳时间,并监测复苏后的心率,血压情况。同时检测患者复苏即刻、复苏后1、3、24h心肌肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白I(TnI)、脑利钠肽(BNP)及高敏C反应蛋白(hs-CRP)的水平。结果:①参附注射液治疗组患者恢复有效自主心跳的时间较对照组明显缩短,血压回升更快;②两组患者心脏恢复灌注后CK-MB、TnI及BNP均呈上升趋势,但治疗组的升高幅度显著低于对照组(P<0.05);③参附注射液治疗显著抑制了心肺复苏后的炎症反应,hs-CRP较对照组明显下降。结论:参附注射液增加了心肺复苏的成功率,减轻复苏后的心肌损伤和心功能障碍。Objective： To explore the effects and mechanism of Shenfu injection on the cardiac arrest patients treated with cardiopulmonary resuscitation （CPR）. Method..32 cases of cardiac arrest patients were randomly divid- ed into two groups and both were treated with CPR. 17 patients were given Shenfu injection when CRP began,-and the others were given 0.9 % sodium chloride only as control. CK-MB, TnI, BNP and hs-CRP in both groups were measured at the beginning of CPR, 1 h, 3 h and 24 h after reperfusion. Result：There was a rising trend of CK- MB, TnI and BNP after heart reperfusion in both groups, but the rising extent in shenfu injection treated group was obviously lower than that in control group （P〈0.05）. Meanwhile, Shenfu injection also significantly de- creased the elevation of hs-CRP after CPR. Conclusion： Shenfu injection attenuates the injury and dysfunction of myocardium after CPR and increase the successful rate of resuscitation.

关 键 词：心肺复苏 心肌损伤 心功能障碍 参附注射液 

分 类 号：R54[医药卫生—心血管疾病]