氨茶碱与肾上腺素对窒息致心脏停搏大鼠心脏硬度影响的研究

Study on the cardiac stiffness of aminophylline and epinephrine in treatment of a rat model of asphyxial cardiac arrest

目的探讨氨茶碱与肾上腺素在大鼠窒息致心脏停搏模型中对心脏硬度的影响。方法采用呼气末夹闭气管方法建立起大鼠心脏停搏模型。48只大鼠随机分为生理盐水对照组(对照组)、氨茶碱组、肾上腺素组、氨茶碱与肾上腺素合用组(合用组),心肺复苏后1h处死动物尸检观察心脏硬度。结果①氨茶碱组心肌硬度记分(2．92±0．79)和肾上腺组(3．92±1．00)均高于对照组(2．17±0．83,P均＜0．05);②合用组心肌硬度记分(2．50±1．09)低于肾上腺组,差异具统计学意义(P=0．003);③氨茶碱组、肾上腺素组和合用组自主循环恢复动物的心脏硬度记分均值均明显低于未恢复者,且差异均具统计学意义(P均＜0．05);④复苏后1h处死动物心脏硬度记分与复苏过程中最高收缩压、舒张压和平均压之间均存在中度正相关(P均＜0．05)。结论在窒息致心脏停搏大鼠模型中肾上腺素与氨茶碱均可导致心脏硬度的增加,这种心脏过度收缩致舒张障碍,即石头心现象,可能是其复苏失败的原因之一。

Objective To investigate the influence on the cardiac stiffness of aminophylline and epinephrine in a rat model of asphyxial cardiac arrest. Methods Asphyxial cardiac arrest was induced by clamping the endotracheal tube. The total 48 rats were divided into four groups, intravenous normal saline （control group）, aminophylline, epinephrine, and mixture of aminophylline and epinephrine （mixture group） in a randomized manner. After lh of CPR the rat hearts were taken and the cardiac stiffness meas- ured. Results （1）The average cardiac stiffness scores in the aminophylline group （ 2. 92 ± 0. 79） and epinephrine group（ 3. 92 ± 1.00 ） were significantly higher than control group （ 2. 17 ± 0. 83, All P 〈 0. 05 ）. （2） The cardiac stiffness score in the mixture group （2. 50 ± 1.09） was lower than epinephrine group, and the difference was significant（P =0. 003）. （3）In the aminophylline, epinephrine and mixture groups, the cardiac stiffness scores in the rats with spontaneous circulation were significantly lower than the rats without spontaneous circulation （ All P 〈 0. 05 ）. （4）There were the mild positive correlation between the cardiac stiffness scores and the highest systolic, diastolic and average blood pressure during the CPR （ All P 〈 0. 05 ）. Conclusion These results suggest that aminophylline and epinephrine could increase the cardiac stiffness in the rat model of asphyxial cardiac arrest. This kind of cardiac muscle over - contraction with diastolic function impairment, the ＂stone heart＂, maybe the one of the failure causes of CPR.