生脉注射液对家兔心搏骤停模型自主循环恢复和复苏早期血流动力学的影响

Effect of shengmai injectio on restoration of spontaneous circulation and hemodynamics in the early stage of resuscitation in rabbit model of cardiac arrest

目的 探索生脉注射液对心搏骤停动物模型的自主循环恢复和复苏后早期血流动力学的影响,为心搏骤停复苏后动物的后续研究提供稳定循环的辅助支持.方法 将家兔30只随机（随机数字法）分成两组各15只,采用窒息法建立心搏骤停动物模型;生脉组在复苏开始即刻给予2mL/kg生脉注射液静注,自主循环恢复后10 min再次给予相同剂量一次;盐水组给药时间和盐水剂量与生脉组相同.记录家兔心搏骤停时间、自主循环恢复时间和自主呼吸恢复时间,分别记录窒息前和自主循环恢复即刻、ROSC后30 min,60 min和120 min的左室收缩压（LVSP）、左室等容收缩期最大上升速率（＋dp/dtmax）和等容舒张期最大下降速率（-dp/dtmax）、左室舒张末压（LVEDP）等血流动力学指标的变化.计算自主循环恢复率与6 h存活率.结果 生脉组和盐水组家兔在心搏骤停时间、自主呼吸恢复时间、自主循环恢复率以及6 h存活率等指标之间的比较,差异无统计学意义（P＞0.05）,但生脉组家兔自主循环恢复时间要明显早于盐水组;两组家兔在自主循环恢复30 min,60min和120 min的左室收缩压（LVSP）、左室等容收缩期最大上升速率（＋dp/dtmax）和等容舒张期最大下降速率（-dp/dtmax）与窒息前相比明显降低,但左室舒张末压（LVEDP）升高（P＜0.05）;生脉组在相应时间点的左室收缩压（LVSP）、左室等容收缩期最大上升速率（＋dp/dtmax）和等容舒张期最大下降速率（-dp/dtmax）高于盐水组,左室舒张末压（LVEDP）低于盐水组（P＜0.05）.结论 生脉注射液辅助用于心搏骤停家兔心肺复苏,可缩短家兔自主循环恢复时间,并且可改善其自主循环恢复后心肌舒缩功能,有利于复苏后血流动力学的稳定.

Objective To explore the effect of shengmai injection （a Chinese herb preparation made from radix astragali and radix rehmanniae） on restoration of spontaneous circulation （ROSC） and hemodynamics in the early stage of resuscitation （CPR） in animal models of cardiac arrest, providing adjuvant support to stabilize the circulation for the facilitation of follow-up study in the resuscitated animal. Method A total of 30 rabbits were randomly（random number） divided into two groups, shengmai group and saline group, （ n = 15 in each group）.Asphyxia method was used to establish animal models of cardiac arrest. In the shengmai group, 2 mL/kg shengmai injection was given immediately just after initiation of CPR and the same dose of shengmai injectio was given once again 10 minutes after ROSC. In the saline group, saline was administered in the same volume and at the same given time instead of shengmai injectio. The duration of cardiac arrest of rabbits, and the lengths of time consumed for ROSC and for resume of spontaneous respiration after CPR as well as the rate of ROSC obtained and 6-hours survival rate after CPR were documented. The changes of hemodynamics including LVSP, ＋ dp/dtmax,- dp/dtmax, LVEDP were recorded before asphyxia,just after the emergence of ROSC and 30 min,60 min, and 120 min after ROSC. Results There were no significant differences in duration of cardiac arrest, length of time consumed for the resume of spontaneous respiration, rate of ROSC obtained and 6-hours survival rate between two groups （P 〉 0.05）, but the ROSC emerged sooner in shengmai group. The LVSP, ＋ dp/dtmax and- dp/dtmaxsignificantly lower 30 min, 60 min and 120 min after ROSC then those before asphyxia in both groups, but LVEDP increased after ROSC （P 〈0.05）. At the corresponding intervals after ROSC, the values of LVSP, ＋ dp/dtmaxand - dp/dtmax in the shengmai group were higher than those in the saline group, and the values of LVEDP in the shengmai group were lower than those in the saline group （ P 〈 0. 05）. Conclusions Shengmai injectio used in rabbits with cardiac arrest can shorten the time consumed for ROSC after CPR, improve cardiac diastolic and systolic function after R OSC, stabilizing the hemodynamics after resuscitation.