左西孟旦提高脂肪乳剂联合肾上腺素解救布比卡因诱导的心脏停搏大鼠的存活率  

Levosimendan improves survival rate in lipid-epinephrine based resuscitation in a rat model of bupivacaine-induced cardiac arrest

作　　者：南芙蓓 吴冰晶[1] 董娇娇[1] 夏云[2] Thomas J.Papadimos 徐旭仲[1] 

机构地区：[1]温州医科大学附属第一医院麻醉科,浙江温州325015 [2]美国俄亥俄州立大学医学中心麻科,俄亥俄州哥伦布43085

出　　处：《温州医学院学报》2015年第8期556-559,565,共5页Journal of Wenzhou Medical College

基　　金：国家自然科学基金资助项目(81470419)

摘　　要：目的:观察在脂肪乳剂联合肾上腺素解救布比卡因诱导的大鼠心脏停搏时,左西孟旦对大鼠停搏心脏的复苏效应。方法:成年雄性SD大鼠24只,随机分为实验组(n=12)和对照组(n=12)。建立大鼠布比卡因心脏骤停模型。常规大鼠心脏按压,用脂肪乳联合小剂量肾上腺素进行心肺复苏,实验组给予左西孟旦,对照组给予0.9%氯化钠溶液进行复苏。记录2组大鼠成功复苏例数、45 min复苏末存活例数,记录首次自主心跳时间、自主循环恢复时间及肾上腺素累计用量,记录肺湿干比,平衡末、45 min末动脉血气。结果:与对照组相比,实验组大鼠生存率显著高于对照组(P<0.05),首次自主心跳时间和自主循环恢复时间实验组显著短于对照组(P<0.05),肾上腺素累积用量实验组显著少于对照组,45 min末实验组大鼠p H、血液碱剩余(BE)、Pa CO2和Pa O2显著优于对照组(P<0.05)。结论:在脂肪乳剂联合肾上腺素解救布比卡因诱导的大鼠心脏停搏时,同时使用左西孟旦能加速大鼠心脏的复苏,提高大鼠存活率。Objective：To observe the effect of levosimendan on resuscitation using lipid combined with epinephrine in a rat model of bupivacaine-induced cardiac arrest.Methods：Twenty-four adult SD male rats were randomly divided into two groups：lipid in combination with both epinephrine and levosimendan（LLE,n=12）or lipid in combination with epinephrine（LE,n=12）.Bupivacaine was injected intravenously to establish a rat model of cardiac arrest.Then regular external chest compression was started,and lipid emulsion combined with a small dose of epinephrine resuscitation was used for resuscitation.Additionally,the experimental group was treated with levosimendan,when the control group was given 0.9% sodium chloride.As our primary outcome was the survival rate at 45 mins,cases of successful resuscitation and rats survived to 45 mins were recorded.Besides,the time to the first heart beat and restoration of spontaneous circulation（ROSC）,the amount of epinephrine,the wet to dry ratio of the lung,and the arterial blood gas data at the end of the balance period and at 45 min were also calculated.Results：The survival rate at 45 min in the LLE group was higher than that in the LE group（P〈0.05）.The time to the first heart beat and ROSC in the LLE group was shorter than that in the LE group（P〈0.05）.The amount of epinephine in LLE group was less than that in the LE group（P〈0.05）.The arterial blood gas data such as PH,BE,Pa CO2 and Pa O2 in the LLE group were all better than those in the LE group at 45 mins（P〈0.05）.Conclusion：In the rat model of lipid-epinephrine based resuscitation from bupivacaine-induced cardiac arrest,the combination with levosimendan improves the survival rate and accelerates the recovery.

关 键 词：布比卡因 心脏骤停 脂肪乳剂 肾上腺素 左西孟旦 心肺复苏 大鼠 

分 类 号：R614[医药卫生—麻醉学]