乙醇联合亚低温治疗对心肺复苏后家兔的脑保护作用  

Effect of alcohol combined with hypothermia on cerebral resuscitation after cardiac arrest in rabbits

作　　者：张立平[1] 张英杰[1] 孙晓曼[1] 张安宁[2] 李培杰[3] 牛芳[3] 

机构地区：[1]兰州大学第二医院神经外二科,甘肃兰州730000 [2]安徽医科大学,安徽合肥230032 [3]兰州大学第二医院内科ICU,甘肃兰州730000

出　　处：《中国急救医学》2015年第6期557-561,I0003,共6页Chinese Journal of Critical Care Medicine

摘　　要：目的：明确乙醇联合亚低温治疗对心肺复苏后家兔脑组织的协同保护作用。方法通过体外致颤法建立家兔心肺复苏模型，80只家兔随机分为五组：假手术组（ A组）、常规复苏组（B组）、局部亚低温组（C组）、乙醇组（D组）、乙醇联合局部亚低温组（E组），每组16只。 A组家兔常温下行麻醉、手术、气管切开并插入T型气管套管但不致颤；B组致颤并行常规复苏；C组自主循环恢复（ ROSC）即刻给予局部亚低温；D组ROSC即刻给予1．5 g／kg乙醇（用0．9％盐水稀释至10 mL）微量泵颈内静脉泵入（15 min内）；E组ROSC后即刻给予1．5 g／kg乙醇（用0．9％盐水稀释至10 mL）微量泵颈内静脉泵入（15 min内）＋局部亚低温。各组于实验前、实验结束后12 h测定血清S100β蛋白含量，并于实验结束后12 h处死动物，测定脑组织含水量、脑坏死体积。结果①血清中S100β蛋白含量：与A组比较，其余四组该指标明显增高（P＜0．05），其中E组升高幅度明显低于B、C、D组（P＜0．05）；②脑组织含水量、脑坏死体积：与A组比较，其余四组脑组织含水量明显增多（P＜0．05），脑坏死体积明显增大（P＜0．05），其中E组脑组织含水量增多幅度、脑坏死体积增大幅度均明显低于B、C、D组（P＜0．05）。结论乙醇联合亚低温治疗对心脏骤停（ CA）后脑组织具有协同保护作用。Objective To investigate the protect affect of ethanol with hypothermia for cardiopulmonary resuscitation （ CPR ） of rabbit brain.Methods Ventricular fibrillation （ VF ） was induced by the external electricity, eighty adult rats were randomly divided into five groups （ n=16 ）：sham-operated group （group A）, control group （group B）, hypothermia group （group C）, alcohol group （ group D ） , alcohol combined with hypothermia group （ group E ） . Group A rabbits were endotracheal intubation, anesthesia and surgery at room temperature, Group B cause cardiac arrest and parallel conventional recovery.Group C give local mild hypothermia after ROSC.Group D were given 1.5 g/kg ethanol （ Diluted with 0.9% saline to 10 mL, pumped through the internal jugular vein by micro-pump in 15 min）, Group E were given 1.5 g/kg ethanol （Diluted with 0.9%saline to 10 mL, pumped through the internal jugular vein by micro-pump in 15 min） with local mild hypothermia after ROSC.Determine the serum content of protein S100βcontent of each group before the trial and 12 h after the trial.Twelve hours after the trial, the rabbits were sacrificed to determine the brain water content ,brain dead volume .Results ①The serum S100βcontent：compared with group A, group B、C、D、E showed a significantly higher serum S100βcontent, especially group B （P〈0.05）;and group E showed the lowest serum S100βcontent among group B、C、D、E （ P 〈0.05 ）; ②The brain water content, brain dead volume：compared with group A, group B、C、D、E showed significantly higher brain water content and brain dead volume, especially group B （P〈0.05）; and group E showed the lowest brain water content, brain dead volume among group B、C、D、E （P〈0.05）.Conclusion Ethanol combined with hypothermia show synergic effects on cerebral resuscitation after cardiac arrest.

关 键 词：乙醇 亚低温 脑保护 心肺复苏 

分 类 号：R473.5[医药卫生—护理学]