胺碘酮联合磷酸肌酸钠对心肺复苏后心肌的保护作用  

Protective effects of amiodarone combined with creatine phosphate sodium on myocardium after cardiopulmonary resuscitation in rabbits

作　　者：王芳[1] 周雨[2] 许铁[2] 

机构地区：[1]南京大学医学院附属南京市鼓楼医院急诊科,江苏南京210008 [2]徐州医学院附属医院急救中心,安徽芜湖221002

出　　处：《中国急救医学》2013年第1期77-81,100,共6页Chinese Journal of Critical Care Medicine

摘　　要：目的研究胺碘酮联合磷酸肌酸钠对兔心肺复苏（CPR）后心肌的保护作用。方法用窒息法制作CPR模型。选取健康日本长耳大白兔40只，随机分为A组（假手术组）、B组（生理盐水组）、C组（胺碘酮组）、D组（磷酸肌酸钠组）、E组（胺碘酮联合磷酸肌酸钠组），每组8只，动态监测HR、MAP及血浆CK、CK—MB含量。复苏后6h处死兔，光镜下观察心肌组织病理学变化。结果B组、C组、D组和E组兔的HR、MAP比较差异无统计学意义（P〉0．05）。与A组比较，CPR后B组、C组、D组和E组兔血浆CK、CK—MB含量均增高，差异有统计学意义（P〈0．05）；其中B组显著高于C组、D组，C组、D组又显著高于E组，差异有统计学意义（P〈0．05）。B组、c组、D组和E组兔血浆的CK、CK—MB含量随时间逐渐增加，各时间点比较差异均有统计学意义（P〈0．05）。心肌组织病理显示，E组心肌损伤轻于c组和D组，c组和D组又轻于B组。结论胺碘酮、磷酸肌酸钠、胺碘酮联合磷酸肌酸钠均对CPR后心肌损伤有保护作用，胺碘酮联合磷酸肌酸钠的保护效果更好。Objective To explore the protective effects of the combination of amiodarone and creatine phosphate sodium on myocardium in the rabbits after cardiopulmonary resuscitation （CPR）. Methods The models of cardiac arrest were established by suffocation method. Forty healthy rabbits were randomly divided into five groups： group A （sham group）, group B （normal salinegroup）, group C （treatment group with amiodarone 5 mg/kg）, group D （treatment group with creatine phosphate sodium 100 mg/kg）, group E （treatment group of amiodarone 5 mg/kg combined with creatine phosphate sodium I00 mg/kg）. Heart rate （ HR）, mean arterial pressure （MAP） and the levels of plasma creatine kinase （CK）, CK -MB were dynamically monitored. The rabbits were all put to death immediately at 6 h after CPR. The pathological changes of myocardium were observed under optical microscope. Results There were no significant differences in HR, MAP among group B, group C, group D and group E （P 〉 0.05）. Compared with group A, the levels of plasma CK, CK - MB were significantly higher in group B, group C, group D and group E after CPR （P 〈 0.05）. Compared with group B, the levels of plasma CK, CK - MB were significantly lower in group C and group D （P 〈 0.05 ） ; compared with group C and group D, the levels of plasma CK, CK - MB were significantly lower in group E （ P 〈 0.05 ）. There were no significant differences in the levels of plasma CK and CK - MB between group C and group D （P 〉 0.05）. In group B, group C, group D and group E, the levels of plasma CK, CK - MB increased gradually after CPR （ P 〈 0.05 ）. Correlation analysis showed that therewas significantly postitive relation between the levels of plasma CK, CK - MB and the time after CPR in group B, group C, group D and group E （P 〈 0.05）. Results of pathology showed that myocardial injury were more seriously in group B than in group C and group D, and myocardial injury were more seriously in group C and group D than in gr

关 键 词：心肺复苏(CPR) 胺碘酮 磷酸肌酸钠 肌酸激酶 肌酸激酶同工酶 

分 类 号：R927.11[医药卫生—药学]