生脉注射液对家兔心肺复苏后多器官功能障碍防治的研究  

Effects of Shenginai Injection on multiple organ failure in post cardiopulmonary resuscitation rabbits

作　　者：张东[1] 李洪祥[1] 陈颖[1] 王育珊[1] 

机构地区：[1]吉林大学第一医院ICU,长春130021

出　　处：《中华急诊医学杂志》2013年第9期989-993,共5页Chinese Journal of Emergency Medicine

基　　金：国家自然科学基金（30870351）;吉林省科技发展计划项目（200705201）

摘　　要：目的观察生脉注射液对心搏骤停家兔复苏后血清肿瘤坏死因子-α（TNF-α）水平和多器官功能指标的干预作用。方法本实验在吉林大学基础医学院生理学实验室完成。将成年中华大耳白兔30只按随机数字表法分成盐水组和生脉组各15只，建立窒息法致心搏骤停动物模型，生脉组在复苏开始即刻给予2ml／kg生脉注射液静注、复苏后10min再次给予相同剂量一次，盐水组给予等量盐水注射。观察两组家兔自主循环恢复（ROSC）率，以及6、12、24、48h不同时间点的存活率；以酶联免疫吸附（ELISA）法检测家兔复苏前与复苏后12、24、48h血清中TNF．d水平；以生化学方法检测上述时间点心肌肌酸激酶同功酶（CK—MB）、谷丙转氨酶（ALT）、肌酐（Cr）、动脉血氧分压（PaO：）、血糖（Glu）等器官功能指标。统计分析采用成组t检验或X。检验，以P〈0．05为差异具有统计学意义。结果两组家兔的ROSC率和复苏后不同时间点的存活率之间比较差异无统计学意义（P〉0．05）。两组家兔窒息前TNF—α水平比较差异无统计学意义（P〉0．05），在ROSC后12、24、48h不同时间点，生脉组家兔血清TNF-α水平明显低于盐水组（P〈0．05）。生脉组家兔在ROSC后24h血清CK—MB、ALT和Cr水平均明显低于盐水组（P〈0．05）；在ROSC后48h血清CK．MB和ALT水平也明显低于盐水组（P〈0．05），Cr水平比较差异无统计学意义（P〉0．05）。两组家兔血糖和动脉血氧分压在不同时间点比较，差异均无统计学意义（P〉0．05）。结论生脉注射液对心搏骤停家兔复苏后血清TNF-α水平有明显的抑制作用，对复苏后心、肝、肾器官功能具有不同程度的保护作用。Objective To observe the effect of Shengmai Injection （a Chinese herbal medicine preparation） on the serum levels of TNF-α used as indicators of organ function in post cardiopulmonary resuscitation rabbits. Methods Rabbit cardiac arrest model was made with asphyxia by clamping the trachea of rabbit. A total of 30 rabbits were randomly （random number） divided into two groups, namely the normal saline group （n = 15 ） and the Shengmai injection group （n = 15 ）. Rabbits in Shengmai injection group were injected with 2 ml/kg Shengmai Injection immediately at the beginning of cardiopulmonary resuscitation （CPR）, and the same dose of Shengmai injection given 10 min after CPR. Rabbits in saline group were injected with the same volume of physiological saline instead at the same intervals as previous group. The rate of restoration of spontaneous circulation （ROSC） and survival rates at 6, 12, 24 and 48 h after ROSC were observed. The serum levels of TNF-o~ were measured by enzyme-linked immunosorbent assay （ ELISA）. Biochemical methods were used to detect myocardial MB-isoeuzyme of creatine kinase （ CK- MB）, alanine aminotransferase （ALT）, creatinine （Cr）, glucose （Glu） and arterial partial pressure of oxygen （PaO2 ） before resuscitation and 12, 24 and 48 h after ROSC simultaneously in the two groups. Results There was no statistically significant difference in the ROSC rate and survival rate after resuscitation between the two groups （ P 〉 0. 05 ）. Before asphyxia, there was no significant difference in the level of TNF-a found between the two groups （ P 〉 0. 05 ） , but at 12, 24 and 48 h after ROSC, the levels of TNF-a in Shengmai group were much lower than those in Saline group （ P 〈 0. 05 ）. At 24 h after ROSC, the levels of serum CK-MB, ALT, and Cr in Shengmai group were much lower than those in Saline group （ P 〈 0. 05 ）. Furthermore, at 48 h after ROSC, the levels of CK-MB and ALT in Shengmai group were still lower than those in Saline group �

关 键 词：心搏骤停 心肺复苏 肿瘤坏死因子-α 生脉注射液 全身炎症反应综合征 多器官功能障碍综合征 

分 类 号：R285.5[医药卫生—中药学]