硝普钠对CPR后大鼠重要脏器微循环血流量的影响  

The effect of sodium nitroprusside on microvascular blood flow of vital organs in a rat modelpost - cardiopulmonary resuscitation

作　　者：刘杰[1] 邓超[2] 黄国庆[1] 邓跃林[1] 

机构地区：[1]中南大学湘雅医院急诊科,湖南长沙410008 [2]中南大学湘雅医学院,湖南长沙410008

出　　处：《中国急救医学》2017年第7期646-652,共7页Chinese Journal of Critical Care Medicine

摘　　要：目的观察硝普钠对心肺复苏（CPR）后大鼠重要脏器微循环血流量的影响，为提高CPR后微循环灌注寻找新的方法。方法将SD大鼠随机分成假手术组（n=8）、对照组（n=8）和实验组（n=8）。假手术组开胸并于实验开始的0min、15min和40rain分别向左心室内3次注射彩色微球。对照组和实验组采用电刺激心外膜法建立心脏骤停（CA）模型，并经CPR达到自主循环恢复（ROSC），对照组于自主循环恢复后15min开始持续静脉泵人生理盐水4mL／h和5％葡萄糖溶液2mL／h；实验组于自主循环恢复后15min持续静脉泵人生理盐水4mL／h和溶解有硝普钠的5％葡萄糖溶液2mL／h（硝普钠浓度为0．01mg／mL）。实验组和对照组分别于致颤前、ROSC后15min和40min分别开胸行左心室内注射彩色微球。第3次微球注射后5min处死大鼠，取心、脑、肾、胃、肠、肺等重要脏器，消化组织并回收微球，通过微球计数间接反映重要脏器微循环血流量的变化情况。结果①假手术组3个时间点单位质量微球数比较差异无统计学意义（P〉0．05）。②对照组和实验组复苏后15min与致颤前比较，心、脑、肾、胃、肠等脏器单位质量微球数及肺脏单位质量微球数减少（P〈0．05）。③对照组复苏后40min与复苏后15min比较，心、脑、肾、胃、肠、肺等脏器单位质量微球数的比较差异无统计学意义（P〉0．05）；实验组复苏后40rain与复苏后15min比较心、脑、肾、胃、肠等脏器单位质量微球数增加（P〈0．05），肺脏单位质量微球数增加（P〈0．05）。结论①CA大鼠经复苏达到ROSC后，心、脑、肾、胃、肠的微循环血流量均减少。②硝普钠可以改善大鼠CPR后40min重要脏器微循环血流量。Objective We investigated the effect of sodium nitroprusside on microvascular blood flow of vital organs in a rat model after cardiopulmonary resuscitation （CPR） , in order to find new ways for improving microcirculation peffusion after cardiopulmonary resuscitation （CPR） in rats. Methods SD rats as experimental subjects after anesthetizing, fixing, endotracheal intubating and catheterizating of femoral artery and femoral vein, the rats were randomly divided into the sham group （ n = 8 ） , control group （ n = 8） and experimental group （n = 8）. Sham group： thoracotomy at the beginning of the experiment and injected colored microsphcres into the left ventricle at the time of 0 min, 15 min and 40 rain. Control group and the experimental group were stimulated epicardially by electrical to establish cardiac arrest model, and cardiopulmonary resuscitation was carried out to achieve return of spontaneous circulation. The control group was infused normal saline 4 mL per hour and 5% glucose solution 2 mL per hour 15 rain after the restoration of spontaneous circulation. Experimental group was infused normal saline 4 mL per hour and 5% glucose solution 2 mL per hour which soluted sodium nitroprusside 15 min after restoration of spontaneous circulation （SNP concentration of 0. 01 mg/mL）. Before the cause fibrillation, 15 rain and 40 rain after the restoration of spontaneous circulation, experimental group andcontrol group were thoracotomyed and injected colored microspheres into the left ventricle. 5 min after the third microsphere was injected, rats were killed and heart brain, kidney, stomach, intestine, lung tissues were sampled, then the tissues were digested and microspheres were recovered to calculate the microcirculatory blood flow in vital organs. Results （1）The number of the microspheres in per gram tissue at three time points of Sham group had no significant differences （ P 〉 O. 05 ）. （2）In the control group and the experimental group, compared with the before fibrillation t

关 键 词：心脏骤停(CA) 心肺复苏(CPR) 硝普钠(SNP) 微循环 血流量 

分 类 号：R657.302[医药卫生—外科学]