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复苏早期应用氨茶碱对心肌超微结构的影响 被引量:12

Effect of Aminophylline on ultra structure changes in myocardium at the early stage of cardiopulmonary resuscitation in rats with sudden cardiac arrest
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摘要 目的研究心搏骤停大鼠心肺复苏早期应用氨茶碱对复苏成功率、血液流变学、心功能及大鼠心肌超微结构的影响。方法选60只SD大鼠,随机分为3组:手术对照组(A组),肾上腺素治疗组(B组)和肾上腺素+氨茶碱治疗组(C组),各20只。分别于窒息前、自主循环恢复时及自主循环恢复30min后进行血流动力学及心功能测定,电镜观察心肌超微结构的变化。结果比较自主循环恢复时间,C组明显少于B组(P<0.05)。C组中有75%自主循环恢复,30min存活率为70%,B组分别为60%(P>0.05)和55%(P>0.05)。C组自主循环恢复时及自主循环恢复30min后的LVSP、dp/dtmax、经LVSP校正后的dp/dt和-dp/dt均明显高于B组(P<0.05)。A组心肌细胞超微结构正常,C组复苏后心肌超微结构略有部分改变,线粒体轻度肿胀及少量空泡形成。B组复苏后心肌细胞部分损害,心肌细胞肌丝排列不整齐,线粒体明显肿胀及空泡化,损害程度比C组严重。结论在复苏早期应用腺苷受体拮抗剂氨茶碱提高了复苏成功率,并且改善了心脏功能,减少了对心肌细胞超微结构的破坏,因此,氨茶碱可作为肾上腺素的增补剂。 Objective To study effects of Aminophylline on successful rate of resuscitation,hemorheology,cardiac function and ultra structure changes in myocardium at the early stage of cardiopulmonary resuscitation in rats with sudden cardiac arrest.Methods Sixty SD rats were randomly divided into three groups:operation control(group A),Epinephrine treatment(group B),Aminophylline and Epinephrine treatment(group C).Cardiac arrest models were induced by asphyxiation in rats,and CPR was performed.Hemorheology and cardiac function were determined before asphyxiation,at spontaneous circulation recovery and 30 minutes after recovery.Ultra structure changes in myocardium were observed under electron microscopy.Results Baseline characteristics were similar in the three groups.The duration of circulation recovery in group C was less than that in group B(P<0.05).The recovery rate of spontaneous circulation and survival rate at 30 minutes were 75% and 70% in group C,while 60%(P>0.05)and 55%(P>0.05)in group B.The LVSP,dp/dt_ max,dp/dt/LVSP and-dp/dt/ LVSP in group C at spontaneous circulation recovery and 30 minutes after recovery were greater than those in group B(P<0.05).No abnormal alterations in myocardial ultra structure were observed in group A.At 30 minutes after CPR,mild changes occurred in group C,including mild mitochondriat swelling and vacuolization.In group B,partial lesions in myocardium ultra structure were observed,including abnormality of myofilament arrangement and mitochondrial swelling and vacuolization remarkably.The severity of myocardium damage was much greater in group B than in group C.Conclusion As adenosine receptor antagonism,Aminophylline used early in CPR would increase the success rate of resuscitation,improve cardiac function and diminish the damage of myocardium ultra structure.
出处 《中华急诊医学杂志》 CAS CSCD 2005年第5期368-372,共5页 Chinese Journal of Emergency Medicine
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