血管加压素联合肾上腺素对心室颤动犬模型心肺复苏的作用  

Therapeutic effect of epinephrine combined with vasopressin on cardiopulmonary resuscitation

作　　者：刘焕兵[1] 吴印生[1] 方继伟[1] 

机构地区：[1]南昌大学第一附属医院干部病房,南昌330006

出　　处：《临床心血管病杂志》2013年第8期621-623,共3页Journal of Clinical Cardiology

摘　　要：目的:评估血管加压素联合应用肾上腺素对心室颤动(室颤)犬模型心肺复苏(CPR)的作用。方法:选取健康杂种犬28只,成功建立室颤模型并给予基本生命支持心肺复苏(BLS-CPR)后,随机分为4组,每组7只。A组首剂应用肾上腺素45μg/kg,B1组首剂应用肾上腺素45μg/kg+血管加压素0.4U/kg,B2组首剂应用肾上腺素45μg/kg+血管加压素0.8U/kg,B3组首剂应用肾上腺素45μg/kg+血管加压素2.4U/kg。4组实验犬应用首剂药物后若未恢复自主循环,以后每3min静脉重复应用首次剂量,共静脉用药3次,期间仍进行持续心肺复苏,以自主循环、心脏停搏或持续室颤作为终点。成功达到自主循环后继续监测30min。结果:在实施BLS-CPR并行电除颤后,A组达到自主循环的仅2只(28.6%),B1组6只(85.7%),B2组和B3组均达到100%,且自主循环所需时间B1组为(74.9±6.52)s,B2组为(71.6±4.89)s,B3组为(70.4±5.66)s,均短于A组[(81.2±6.50)s](均P<0.01)。结论:在心肺复苏过程中,血管加压素和肾上腺素联合应用可以显著地增加冠状动脉灌注压,其中血管加压素的剂量以0.8U/kg最适宜。Objective： To evaluate the effects of vasopressin combined with epinephrine on the dog model of duration ventricular fibrillation during cardiopulmonary resuscitation （CPR）. Method： After modelled ventricular fibrillation and given basic life support cardiopulmonary resuscitation （BLS-CPR） for 3 min, 28 healthy mongrel dogs were randomly assigned to 4 groups and provided with drugs intravenously every 3 min. Group A received only epinephrine （45 /~g/kg, n= 7）, group B1 was treated with epinephrine （45 /~g/kg） combined with vasopres- sin （0.4 U/kg）, group B2 was treated with epinephrine （45 vg/kg） combined with vasopressin （0.8 U/kg）, and group Ba was treated with epinephrine （45 ~g/kg） combined with vasopressin （2.4 U/kg）. The terminal point is the return of spontaneous circulation, cardiac arrest, or continuous ventrieular fibrillation. Result： Only two ani- mals （28.6%） in group A had return of spontaneous circulation, and six （85.70/oo） in group B1 after the execution of BLS-CPR and electric defribrillation, both B2 and B3 achieved 100G. The time of the return of spontaneous cir culation was （74.9-t-6.52）s in group B1, （71.6＋_4.89）s in group B2, （70.4＋5.66）s in group B3 respectively, all shorter than that of group A （all P^0. 01）. Conclusion：During CPR in ventricular fibrillation, administration of vaso- pressin combined with epinephrine results in significant increases in CPP, and the best dosage of vasopressin is 0. 8 U/kg.

关 键 词：血管加压素 肾上腺素 联合用药 冠状动脉灌注压 心肺复苏 

分 类 号：R541.7[医药卫生—心血管疾病]