乌司他丁对心肺复苏后家猪脑功能保护的作用  

Effects of ulinastatin on brain protection after cardiopulmonary resuscitation in a porcine model

作　　者：武军元[1] 王烁[1] 李春盛[1] 袁伟[1] 

机构地区：[1]首都医科大学附属北京朝阳医院急诊科,北京100020

出　　处：《中华急诊医学杂志》2013年第1期18-22,共5页Chinese Journal of Emergency Medicine

基　　金：北京市优秀博士学位论文指导教师科研项目（20121002501）

摘　　要：目的通过制作猪心肺复苏动物模型，于复苏后应用乌司他丁（UTI），评价其对心肺复苏后脑保护的作用。方法雌性家猪20头，通过程控刺激法制作心室颤动动物模型，室颤8min后开始心肺复苏，恢复自主循环的家猪随机（随机数字法）分为两组：①UTI组，复苏后立即开始给予UTI，每次10万U溶于生理盐水5ml，缓慢注射，每3h1次，直到复苏后24h（第24小时不给药）；②对照组，复苏后应用生理盐水5ml作为对照，给药时间和次数同实验组。分别于基础状态、复苏后即刻、复苏后3、12及24h抽取家猪静脉血备用测定TNF-α和IL-1β水平。复苏后24h行神经功能评分（CPC评分），然后处死家猪，留取脑组织进行普通光镜病理及超微结构检查。结果20头家猪经过8min心室颤动后复苏成功15头。复苏后UTI组（n=8）和对照组（n=7）实验猪均存活24h。复苏后3、12和24hUTI组的TNF-α和IL-1β水平明显低于对照组（均P〈0．05）。UTI组家猪24hCPC评分好于对照组（P〈0．05）。24hUTI组脑组织损伤程度明显轻于对照组。结论复苏后应用UTI可以减轻脑组织损伤，改善脑功能恢复。Objective To evaluate the effects of ulinastatin （UTI） on brain protection after eardiopulmonary resuscitation in a porcine model. Methods A total of 20 female swine were induced to make ventricular fibrillation （ VF ） by programmed stimulation method, and CPR was stared after 8 rains after VF. Swine after ROSC （return of spontaneous circulation） were randomly （random number） divided into two groups, namely UTI group and control group. In UTI group, UTI was administered slowly in a dose of 100 000 U dissolved in 5 ml saline immediately after resuscitation and then given every 3 h until 24 h after CPR （ UTI not given at the time of 24 h） ; and 5 ml saline was used instead in control group. Venous blood samples were taken separately before VF, immediate after resuscitation and 3 h, 12 h and 24 h after ROSC for detecting levels of TNF-α and IL-1 β. Cerebral performance category （ CPC ） scores were assessed 24 h after ROSC, and subsequently the swine were sacrificed to get brain specimens for histopathologieal and uhrastructural examination under ordinary light microscope. Results Fifteen of twenty domestic swine were successfully rescued 8 rains after ventricular fibrillation. Swine of UTI group （ n = 8 ） and control group （ n = 7 ） were all survived over 24 h. Both TNF-α and IL-1 β levels were significantly lower in UTI group than those in control group at intervals of 3 h, 12 h and 24 h after ROSC （ P 〈 0. 05 ）. Twenty-four hours after ROSC, CPC scores of swine were higher in UTI group than those in control group （ P 〈 0. 05 ）. The brain injury 24 h after ROSC was significantly attenuated in UTI group than that in control group. Conclusions UTI can reduce the injury of brain tissue and improve the recovery of cerebral function after CPR.

关 键 词：心肺复苏 乌司他丁 炎症因子 CPC评分 脑保护 猪 

分 类 号：R45[医药卫生—治疗学]