磷酸肌酸对窒息型大鼠心肺复苏后心肌保护作用的研究

Protective effect of exogenous phosphocreatine on myocardial injury after cardiopulmonary resuscitation in rats

目的探讨磷酸肌酸(CP)对大鼠心肺复苏(CPR)后血清肌酸激酶同工酶(CK-MB)、肌钙蛋白I(cTnI)和心肌组织病理损伤的影响。方法将32只成年雄性SD大鼠随机分为复苏组(A组)、小剂量CP组(B组,于CPR开始时首次给CP0.5g/kg,2h后再次给1.0g/kg)、大剂量CP组(C组,于开始复苏时首次给CP1.0g/kg,2h后再次给2.0g/kg),对照组(D组),每组8只。建立窒息型大鼠心跳骤停和CPR模型。分别于自主循环恢复(ROSC)后(A、B、C组)或气管插管后(D组)6、12、24h取血,测定血清CK-MB和cTnI的含量。取各组大鼠心肌组织于光镜下观察病理学改变。结果与D组比较,A、B和C组各时间点血清CK-MB和cTnI含量均显著增高(均P<0.01)。与A组比较,B、C组各时间点血清CK-MB和cTnI含量均显著降低(P<0.05或0.01)。与B组比较,C组各时间点的血清CK-MB和cTnI含量均显著降低(P<0.05或0.01)。心肌组织病理改变显示,B、C组心肌结构损伤程度明显轻于A组,C组轻于B组。结论外源性CP可减轻大鼠CPR后心肌损伤,在大剂量给药时作用更加明显。

Objective TO study the protective effects of exogenous phosphocreatine （CP） on myocardium injury after cardiopulmonary resuscitation （CPR） in rats. Methods Thirty two adult male SD rats were randomly divided into 4 groups： CPR group （group A）, low-dose CP group （group B, CP 0.5g/kg at beginning of CPR and 1.0g/kg 2h later） and high-dose CP group （group C, CP 1.0g/kg at beginning of CPR and 2.0g/kg 2h later） , control group （group D）. Asphyxiation cardiac arrest and CPR model was used in the study. Blood samples were taken at 6h, 12h, 24h after incision of trachea （in group D） or after restoration of spontaneous circulation （in group A, B and C）, and serum creatine kinase isoenzyme （CK- MB） and cardiac troponin I （cTnl） were measured. The pathological changes of myocardium were observed under optical microscope. Results Compared with group D, The levels of serum CK- MB and cTnl were significantly higher in group A, B and C at each time point （P 〈 0.01）. Compared with group A, the levels of CK- MB and cTnl were significantly lower in group B and C at each time point （P 〈 0.05 or 0.01 ）. Compared with group B, the levels of CK- MB and cTnl were significantly lower in group C at each time point （P 〈 0.05 or 0.01 ）. The histopathological changes of myocardium were milder in groups B and C than those in group B, and those in group C were mildest. Conclusion Treatment with exogenous CP, especially in high-dose can alleviate myocardial injury after CPR in rats.