腺苷对窒息大鼠复苏及心肌微循环的影响

Effects of continuous adenosine infusion on cardiac microcirculation in asphyxia Wistar rats during cardiopulmonary resuscitation （CPR）

目的 观察腺苷在窒息大鼠心肺复苏中对复苏成功率和心肌微循环的影响。方法 采用窒息法制作大鼠窒息模型，将实验动物随机分为对照组（A组）、肾上腺素组（B组）和肾上腺素合并腺苷组（C组）。持续窒息3min后，行胸外心脏按压，呼吸机辅助呼吸，4min后静脉给药。A组（n=15）不用复苏药物；B组（n=14）静脉注射肾上腺素90μg·kg^-1；C组（n=14）静脉注射肾上腺素90μg·kg^-1并持续静滴腺苷70μg·kg^-1·min^-1至复苏结束。观察自主循环恢复率、复苏成功率和心肌微循环。结果 C组自主循环恢复率（92．9％）和复苏成功率（64．3％）〉B组（78．6％，50％）〉A组（60％，20％）；C组心肌毛细血管数目和面积好于A组和B组。结论 心肺复苏时肾上腺素合并腺苷可能会减轻肾上腺素部分负作用，改善大鼠心肌微循环，提高复苏成功率。

Objective To study the effects of continuous adenosine infusion on cardiac microcirculation in Wistar rats during cardiopulmonary resuscitation. Method Healthy Wistar rats subjected to cardiac arrest and resuscitation were randomly divided into normal saline group （A）, epinephrine group （B）, epinephrine plus adenosine group （C）. After a 3-minute- non-intervention interval, CPR started. After 4 minutes of CPR the animals in group A received normal saline, group B received epinephrine （bolus dose of 90 mg·kg^- 1 ）, and group C epinephrine plus adenosine （bolus dose of 90 mg·kg^-1 epinephrine followed by continuous adenosine infusion of 70 μg·kg^- 1. min^- 1 ）. The rate of restoration of spontaneous circulation （ ROSC ）, the rate of successful CPR, and the numbers and area of cardiac blood capillary were observed. Results With the rate of ROSC and successful CPR, and the numbers and area of cardiac blood capillaryas criteria for comparison, group C was better than group B and A. Conclusions Adenosine could ameliorate side effects of epinephrine in CPR, improve cardiac microcirculation and raise successful rate of resuscitation.