补阳还五汤对窒息型大鼠心肺复苏后心肌损伤的影响  

Effect of Buyang Huanwu Decoction on Myocardial Injury after Cardiopulmonary Resuscitation in Asphyxiation Rats

作　　者：陈琨[1] 程江华[1] 李章平[2] 李惠萍[2] 黄唯佳[2] 

机构地区：[1]浙江省金华市中心医院急诊科,金华321000 [2]温州医学院附属第一医院急诊科

出　　处：《浙江中西医结合杂志》2012年第9期671-674,677,共5页Zhejiang Journal of Integrated Traditional Chinese and Western Medicine

基　　金：浙江省中医药科技计划项目(No.2008CA072)

摘　　要：目的:观察补阳还五汤(BHD)对窒息型大鼠心肺复苏后心肌损伤的影响。方法:成年雄性SD大鼠24只,随机分为假手术对照组、复苏组、BHD组,每组8只。建立窒息型大鼠心肺复苏模型,测定复苏后早期左心室血流动力学指标,并于复苏24h取样,检测血清心肌酶变化。结果:与假手术对照组比较,复苏组和BHD组大鼠心率在自主循环恢复(ROSC)后0.5h、1h和2h均明显下降(P<0.01),左心室收缩压(LVSP)在ROSC后0.5h和1h明显下降(P<0.01),左心室舒张末压(LVEDP)在ROSC即刻和0.5h明显上升(P<0.01或P<0.05),左室内压的最大上升速率(+dp/dt max)在ROSC后0.5h、1h和2h均明显下降(P<0.01或P<0.05),左室内压的最大下降速率(-dp/dtmax)在ROSC后0.5h、1h和2h均明显下降(P<0.01或P<0.05)。与复苏组各时间点比较,BHD组心率、LVSP、LVEDP、+dp/dtmax和-dp/dtmax变化差异均无统计学意义(P>0.05)。与假手术对照组比较,复苏组和BHD组大鼠的血清CK-MB和cTnI均显著升高(P<0.01);与复苏组比较,BHD组血清CK-MB和cTnI浓度明显降低(P<0.01)。结论:窒息型大鼠心肺复苏早期出现心肌血流动力学指标和生化指标的异常,心肌收缩、舒张功能受损。补阳还五汤不能直接改善血流动力学,但能降低心肌酶学水平,减轻心肌细胞损伤。Objective：To observe the effects of Buyang Huanwu Decoction（BHD） on myocardial injury after cardiopulmonary resuscitation（CPR） in asphyxiation rats.Methods： Twenty male adult SD rats were randomly divided into 3 groups： sham-operation control group,CPR group,and BHD group.Asphyxiation cardiac arrest model was used and early left ventricular hemodynamic parameters were measured after restoration of spontaneous circulation（ROSC）.Serum samples were taken on 24h after ROSC to measure serum myocardial enzymes.Results： Compared with the sham operation group,the heart rate at 0.5h,1h and 2h after ROSC significantly decreased in the CPR group and BHD group（P〈0.01）;left ventricular systolic pressure（LVSP） at 0.5h and 1 h after ROSC markedly decreased（P〈0.01）;left ventricular diastolic end diastolic pressure（LVEDP） at ROSC instantly and 0.5h later dramatically increased（P〈0.01 or P〈0.05）;he maximum rising rate of left intraventricular pressure（＋ dp/ dtmax） at 0.5h,1h and 2h after ROSC significantly decreased（P〈0.01 or P〈0.05）;and the biggest decline of left intraventricular pressure rate（-dp/dtmax） at 0.5h,1h and 2h after ROSC were significantly decreased（P〈0.01 or P〈0.05）.Compared with the CPR group at each time point,the changes of heart rate,LVSP,LVEDP,＋ dp/ dtmax,and-dp/dtmax were not statistically different in the BHD group（P〉0.05）.Compared with the sham operation group,the serum CK-MB and cTnI were significantly increased in the CPR group and BHD group（P〈0.01）;compared with the CPR group,the serum CK-MB and cTnI were decreased significantly in the BHD group（P〈0.01）.Conclusion： The myocardial hemodynamic parameters and biochemical indexes were abnormal in early CPR rat model,with impaired myocardial systolic and diastolic function.Buyang Huanwu Decoction had no direct effect on improvement of hemodynamics,but it can reduce the myocardial enzyme level and ease the myocardial cell injury in asphyxiation rats.

关 键 词：大鼠 心肺复苏 心脏血流动力学 肌酸激酶同工酶 肌钙蛋白I 补阳还五汤 

分 类 号：R285.5[医药卫生—中药学]