窒息家兔心肺复苏疗效与血浆内皮素变化的关系

The relationship between the curative effects of cardiopulmonary resuscitation and the change of plasma endothelin concentrations in asphyxiated rabbits

目的探讨窒息家兔心肺复苏(cardiopulmonaryresuscitation,CPR)疗效与血浆内皮素(endothelin,ET)变化的关系。方法对62只家兔均在呼气末夹闭气管8min,造成窒息性心脏停搏模型后,开始人工胸外心脏按压及机械通气,期间不用任何药物,复苏5min内恢复自主循环(restorationof spontaneouscirculation,ROSC)的家兔定义为常规CPR成功;对5min内未能ROSC者再随机分为两组,分别给予肾上腺素(0.2mg kg)和加压素(0.8U kg)静脉注射,并继续行常规CPR。分别在窒息前和CPR15、60、120min采血测血浆ET浓度。结果常规CPR的家兔ROSC率为24.16%(1562),加用肾上腺素和加压素后总的ROSC率提高到48.39%(3062)。对常规CPR失败的家兔而言,肾上腺素疗效明显优于加压素(ROSC率分别为54.16%和8.70%,P=0.001)。但复苏成功组和复苏失败组家兔血浆ET的比较,差异无显著性。结论对窒息性心脏停搏的家兔CPR时应用肾上腺素或加压素可提高ROSC率,但肾上腺素疗效明显优于加压素。窒息家兔CPR疗效与血浆内皮素变化无明显相关关系。

Objective To study the relationship between the curative effects of cardiopulmonary resuscitation （CPR） and the changes of plasma endothelin （ET） concentrations in asphyxiated rabbits. Methods A prospective ＂CPR without or with drugs＂ intervention study was carried out in asphyxial rabbit with cardiac arrest. Sixty-two rabbits were anesthetized and instrtunented for hemodynamic monitoring. Asphyxiated arrest was produced by clamping the endotracbeal tube. Hemedynamic data were collected continuously. At 8 minutes after the endotracheal tube bad been clamped, the rabbits received closed-cbest CPR without any drug. The animals who had restoration of spontaneous circulation within 5 minutes from CPR were defined as successfully resuscitated rabbits, otherwise as not-resuscitated ones. The latter were randomly assigned to receive epinephrine （0.2 mg/kg） and vasopressin （0.8 U/kg） and kept on CPR. Blood samples were drawn before asphyxia and at 15, 60 and 120 minutes after CPR. Plasma ET concentrations were measured by radioimmunoassays. Results The success rate of resuscitation was 24.19% （15/62） without any drug within 5 minutes of CPR, and increased to 48.39% （30/62） after epinephrine and vasopressin administration. The success rate of resuscitation was significantly higher in the epinephrine group compared with the vasopressin group （13/24 vs. 2/23, P=0.001）. However, the plasma concentration of ET in resuscitated and in not resuscitated animals was not significantly different. Conclusion The success rate of resuscitation increased after epinephrine and vasopressin administration. Epinephrine was more effective compared with vasopressin in an asphyxiated rabbit model of CPR. But there was no relationship between the curative effect of CPR in asphyxial rabbits cardiac arrest and the changes of plasma ET concentrations in rabbits.