亚低温治疗对心肺复苏后大鼠膈肌功能的影响  

Effect of mild hypothermia therapy on diaphragmatic function in a rat model of cardiopulmonary resuscitation

作　　者：严宇 周贤龙[1] 邹星南 卢梓俊 赵剡[1] Yu YAN;Xian-Long ZHOU;Xing-Nan ZOU;Zi-Jun LU;Yan ZHAO(Emergency Center,Zhongnan Hospital of Wuhan University,Wuhan 430071,China)

机构地区：[1]武汉大学中南医院急救中心,武汉430071

出　　处：《数理医药学杂志》2023年第4期246-253,共8页Journal of Mathematical Medicine

基　　金：国家自然科学基金项目(81900097)。

摘　　要：目的探讨亚低温治疗对心肺复苏后大鼠膈肌功能的影响及潜在机制。方法将46只雄性Wistar大鼠随机分为对照组(Sham)、正常体温组(NT)、正常体温复苏组(NTR)、亚低温组(MT)、亚低温复苏组(MTR),Sham组6只、其余实验组每组各10只。NTR组和MTR组大鼠心肺复苏后体温分别维持在37±0.5℃和(33±0.5℃)机械通气12小时,NT组和MT组大鼠行假手术后体温分别维持在37±0.5℃和(33±0.5℃)持续机械通气12小时,Sham组大鼠行假手术后体温维持在37℃自主呼吸12小时。实验结束后检测膈肌收缩力、纤维横截面积(cross-sectional area,CSA)、丙二醛(malonicdialdehyde,MDA)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)和白细胞介素-6(interleukin 6,IL-6)水平,并评估膈肌形态结构变化。结果与Sham组相比,各实验组膈肌收缩力和纤维横截面积显著降低(P<0.05);与MT组相比,NT组、NTR组和MTR组膈肌收缩力和纤维横截面积也显著降低(P<0.05),膈肌MDA、TNF-α和IL-6水平则均显著升高;与NTR组相比,MTR组膈肌收缩力和肌纤维横截面积显著升高(P<0.05),膈肌MDA、TNF-α和IL-6水平则均显著降低(P<0.05)。结论亚低温可以显著改善心肺复苏后的膈肌收缩力下降和纤维萎缩,可能与其抑制炎症反应、减轻氧化应激损伤有关。Objective To investigate the effect of mild hypothermia on diaphragmatic function and its underlying mechanisms in a murine model of post-cardiopulmonary resuscitation.Method Forty male Wistar rats were randomly assigned into one of five groups:a sham control group(Sham,n=6),a normothermia group(NT,n=10),a normothermia resuscitated group(NTR,n=10),a mild hypothermia group(MT,n=10),and a mild hypothermia resuscitated group(MTR,n=10).The body temperature of rats in NTR and MTR groups were maintained at(37±0.5°C)and(33±0.5°C)after cardiopulmonary resuscitation,respectively and the rats were mechanically ventilated for 12 hours.The body temperature of rats in NT and MT groups were maintained at 37±0.5°C and(33±0.5°C)after sham surgery and the rats were kept on mechanical ventilation for 12 h.The body temperatures of rats in Sham group were maintained at 37±0.5°C after sham surgery and the rats breathed spontaneously for 12 h.At the end of experiments,diaphragmatic contractile properties and cross-sectional area(cross-sectional area,CSA),levels of malondialdehyde,TNF-αand IL-6 in the diaphragm were measured.Morphological change of the diaphragm was also observed by routine staining.Result Diaphragmatic contractile properties and CSAs were decreased in all the interventional groups in comparison with the Sham group(P<0.05).Compared with MT group,diaphragmatic contractile properties and CSAs were also significantly decreased,otherwise,levels of MDA,TNF-αand IL-6 were increased in the NT,NTR and MTR group(P<0.05).Compared with NTR group,diaphragmatic contractile properties and CSAs were significantly increased,whereas levels of MDA,TNF-αand IL-6 were significantly decreased in the MTR group(P<0.05).Conclusion Mild hypothermia alleviates the reduction of diaphragmatic contractile properties and fiber size after cardiopulmonary resuscitation,and these beneficial effects potentially associated with inflammatory response inhibition and oxidative stress amelioration in the diaphragm.

关 键 词：亚低温 心肺复苏 膈肌 氧化应激 炎症反应 

分 类 号：R459.7[医药卫生—急诊医学]