腺苷对复苏兔心肌及脑组织变化的干预

The Effect of Adenosine on the Damage of Myocardium and Hippocampus of Asphyxia Rabbits During Cardiopulmonary Resuscitation

目的观察腺苷对窒息兔心脑组织病理及心肌酶学的影响。方法采用窒息法制作兔窒息模型,随机分为对照组(A组)、肾上腺素组(B组)、肾上腺素合并腺苷组(C组)。持续窒息4min后,行心肺复苏,4min后静脉给药。A组(n=6)不用复苏药物;B组(n=12)iv肾上腺素0.09mg·kg-1;C组(n=12)iv肾上腺素0.09mg·kg-1并持续静滴腺苷150μg·kg-1·min-1至复苏结束。取左心室和海马HE染色,光镜下观察心肌和海马组织结构改变;采血查血浆肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)浓度。结果B组和C组心肌细胞和海马神经元无明显破坏,B组仅有轻度缺血改变,两组均明显好于A组。复苏成功兔血浆CK、CK-MB浓度,C组<B组。结论复苏时使用中等剂量肾上腺素对心肌细胞和脑神经元细胞影响不大,合并应用腺苷可能会改善复苏成功后心脑功能。

Aim To investigate the change of histopathology in asphyxia rabbits, hippocampns and myoeardium following adenosine infusion during cardiopulmonary resuscitation （CPR）. Methods Healthy rabbits on which asphyxia cardiacarrest and resuscitation were performed were randomly divided into 0.9% saline group （A）, epinephrine group （B）,epinephrine plus adenosine group（C）. After a 4 - min non- intervention interval, CPR was started. After 4 min of CPRthe animals were randomly assigned to receive either 0.9 % saline or epinephrine （ bolus of 0.09mg·kg^-1 ） orepinephrine plus adenosine （bolus of 0.09mg·kg^-1 epinephrine followed by continuous infusion of 150μg·kg^-1. min^-1 adenosine）. The HE method was used to observe pathological changes in hippocampus neurons and myoeardium under optical microscopy. Results There was slight damage to hippocampns neurons and myoeardium in group B and group C, bothof which were better than group A.CK and CK-MB in blood plasma were lower in group C than in group B （ P 〈 0.05）.Conclusion A middle dose of epinephrine does slight damage to hippocampns neurons and myoeardium during CPR.Epinephrine plus adenosine may improve the function of brain and heart after successful CPR.