氢气减轻家兔心搏骤停后脑损伤  

Hydrogen can alleviate post-cardiac arrest brain injury in rabbits

作　　者：王金高[1] 蔺际龚[1] 孔德全[1] 张自立[1] 俞祥玫[1] 刘加权[1] 蔡冬梅[1] 

机构地区：[1]厦门大学附属厦门第一医院急诊部,福建省厦门361003

出　　处：《中华急诊医学杂志》2012年第10期1111-1115,共5页Chinese Journal of Emergency Medicine

基　　金：福建省医学创新课题（2011-CXB-31）

摘　　要：目的探讨氢气（hydrogen,H2）干预对心搏骤停后脑损伤的作用。方法实验在厦门大学动物实验中心进行，新西兰白兔60只，随机（随机数字法）分为2组：A组为2%氢气干预，B组为空气对照。比较血清中肿瘤坏死因子-α（tumornecrosisfactor-a,TNF-α）、神经元特异性條醇化异 性條醇化酶（neuron-specific enolase，NSE）、SlOOp蛋白质量浓度及神经功能缺损评分（neurological deficit scores，NDS）变化，分析全身炎症反应综合征（systemic inflammatory response syndrome， SIRS）诊断数和兔存活数的差异。结果 A、B两组兔自主循环恢复（restoration of spontaneous circulation , ROSC）数量接近，随着时间延长，存活兔减少，到ROSC72h时，A组兔存活数高于B组（x2=4.850，P〈0.05）。心肺复苏（cardiopulmona ryresuscitation,CPR）后B组血中H2质量浓度于ROSC4h达峰值后下降；A组％浓度保持在较高水平上。在R0SC后，两组兔均有不同程度炎症反应发生，R0SC24h时，A组TNF-α质量浓度、SIRS诊断数低于B组（P〈0.05）。两组血清NSE和S100（3质量浓度在CPR后升高，分别于ROSC24h和4h达峰值后下降，A组峰值低于B组（P〈0.05）。两组兔在CPR后NDS分值逐渐下降，ROSC72h时，A组NDS低于B组=-2.689，P=0.013）。结论H2能抑制CPR后炎症反应，减轻心搏骤停后脑损伤。Objective To investigate the effects of hydrogen on post - cardiac arrest brain injury in rabbits. Method Sixty New Zealand rabbits were randomly divided into two groups,namely experiment group （group A, n = 30 ） and control group （ group B, n = 30 ） . Inhalation of 2% hydrogen gas was conferred to rabbits immediately at the end of cardiac arrest modeling for 72 hours in the group A. Air instead was given to rabbits in the group B. Blood samples were collected before cardiac arrest （ CA）,and 4,12,24 and 72 hours after restoration of spontaneous circulation （ ROSC ） in all rabbits for determining the levels of hydrogen, tumor necrosis factor - α （ TNF - α） , neuron 一 specific enolase （ NSE） and protein SlOOp. At the same time, rectal temperature, mean arterial pressure, heart rate and respiration rate were recorded, and the neurologic deficit scoring （ NDS） was carried out. The rate of systemic inflammatory response syndrome （ SIRS） and the rate of survival of rabbits were analyzed. Results There was no significant difference in level of TNF - α activation between group A and group B within 12 h of cardiopulmonary resuscitation （ CPR） . In group A, TNF - α level and the rate of SIRS peaked at 24 hours after CPR,which were higher than those in group B,and then decreased gradually,and the rate of survival was higher than that in group 6 in 72 hours after ROSC,the NSE was lower than that in group B at 24 hours after ROSC. In group B, SlOOp level began to increase significantly 4 hours after CPR, which was higher than that in group A, the level of NDS in group B was higher than that in group A 72 hours after ROSC. Conclusions Inhalation of hydrogen gas lessened inflammation and alleviated the brain injury after CPR.

关 键 词：心肺复苏 全身炎症反应综合征 心搏骤停后综合征 肿瘤坏死因子-Α 神经功能 缺损评分 

分 类 号：R459.7[医药卫生—急诊医学]