心搏骤停大鼠复苏早期应用氨茶碱的研究

Study about Aminophylline at the early stage of resuscitation in the rats with sudden cardiac arrest

目的观察心搏骤停大鼠复苏早期应用氨茶碱对复苏成功率、血流动力学、心功能及血浆腺苷和去甲肾上腺素的影响。方法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。并测定治疗组自主循环恢复30min后及A组血浆腺苷和去甲肾上腺素水平。结果C组自主循环恢复时间明显少于B组(P=0.034)。C组有75%自主循环恢复,30min存活率为70%,B组分别为60%(P=0.501)和55%(P=0.514)。C组自主循环恢复时及自主循环恢复30min后的LVSP、dp/dtmax、dp/dt/LVSP和-dp/dt/LVSP均明显高于B组(P=0.002～0.042)。两个治疗组血浆腺苷及去甲肾上腺素水平均较手术对照组显著升高(P=0.000～0.029),但两个治疗组间无统计学差异。结论复苏早期应用腺苷受体拮抗剂—氨茶碱提高了复苏成功率,并且改善心脏功能,可作为肾上腺素的增补剂。

Objective To observe the effects of Aminophylline at the early stage of resuscitation on successful rate of resuscitation, hemodynamics, cardiac function and the concentration of plasma adenosine and noradrenaline in the 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). Hemodynamics and cardiac functions were determined before asphyxiation, at spontaneous circulation recovery and 30 minutes after spontaneous circulation recovery. The concentration of plasma adenosine and noradrenaline were examined in group A and 30 minutes after spontaneous circulation recovery in group B and group C. Results The time of spontaneous circulation recovery in group C was less than that in group B significantly(P=0.034). The rate of spontaneous circulation recovery and 30 minutes' survival rate was 75% and 70% in group C, while 60% P=0.501) and 55%(P=0.514) in group B respectively. The LVSP,dp/dtmax,dp/dt/LVSP and -dp/dt/ LVSP of group C examined at spontaneous circulation recovery and 30 minutes after spontaneous circulation recovery were greater than those of B group significantly(P=0.002～0.042). The concentration of plasma adenosine and noradrenaline in group B and group C were higher than those in group A significantly, but there was no statistical difference between group B and group C. Conclusion Aminophylline as adenosine receptor antagonism used early in CPR would increase the successful rate of resuscitation and improve cardiac function. Aminophylline can be used in the CPR added to epinephrine.