经膈肌下抬挤心脏复苏法对心脏骤停兔心肌细胞Fas/FasL、Caspase3表达的影响

Effect of heart compression resuscitation under diaphragm on expression of Fas,FasL and Caspase 3 in myocardiac cells of rabbits with sudden cardiac arrest

目的比较两种复苏方法对心搏骤停兔心肌细胞Fas、FasL、Caspase3表达及凋亡的影响,为开腹手术中发生的心跳骤停选择更合适的复苏方法提供参考。方法分别采用经膈肌下抬挤心脏复苏法与标准心肺复苏法(Cardiopulmonaryresuscitation,CPR)对开腹手术中窒息致心搏骤停兔进行复苏,计算6 h存活率,免疫组织化学染色法检测复苏成功6 h后心肌细胞Fas、FasL、Caspase3的表达,TUNEL法检测细胞凋亡情况。结果经膈肌下抬挤心脏复苏组6 h存活率显著高于标准心肺复苏组,差异有统计学意义(P<0.05),心肌细胞Fas、FasL、Caspase3表达及心肌细胞凋亡率显著低于标准心肺复苏组,差异有统计学意义(P<0.05)。结论开腹手术发生心搏骤停时,膈肌下抬挤心脏复苏法较标准心肺复苏法复苏成功率高,可能与前者能减少心肌细胞凋亡,减轻缺血再灌注损伤有关。

Objective To compare effect of heart compression under diaphragm and chest compression on expression of Fas, FasL and Caspase 3 and apoptosis in myoeardiac cells of sudden cardiac arrest rabbits, and offer a more feasible method for resuscitation of sudden cardiac arrest in laparotomy. Methods The rabbits undergoing laparotomy were inflicted with cardiac arrest by apnea, and were resuscitated by heart compression under diaphragm and chest compression. The 6h survival rates were calculated and the expression of Fas, FasL and Caspase3 and apoptosis in myocardiac cells of resuscitated rabbits were assayed by immunohistochemieal staining technique and TUNEL. Results The 6 h survival rate in rabbits resuscitated by heart compression under diaphragm was higher than that by chest compression, and the expression of Fas, FasL, Caspase 3 and the apoptosis in myocardiac cells were lower than those by chest compression. Conclusions The success rate of resuscitation by heart compression under diaphragm is higher than that by chest compression in laparotomy, because the former method decreases the apoptosis of myoeardiac cells and relieves the isehemia reperfusion injury.