肾上腺素联合艾司洛尔对心室颤动复苏模型家兔肺水肿的影响

Combination of epinephrine and esmolol meliorates pulmonary edema in ventricular fibrillation rabbit model

目的:探讨肾上腺素联合艾司洛尔对心室颤动复苏家兔复苏早期肺水肿及心脏标志物的影响。方法:将26只清洁级家兔随机分为3组,其中20只清洁级家兔采用交流电致心室颤动建立心肺复苏模型,另6只为手术对照组(A组),仅行麻醉、手术、气管插管,不制作心肺复苏模型。模型家兔随机均分10只,分别在复苏时给予肾上腺素10μg/kg(B组)和在复苏时给予肾上腺素10μg/kg+艾司洛尔200μg/kg(C组)。测量复苏成功后5 h肺湿/干比重,比较复苏后30 min、1 h、2 h、4 h时血清肌钙蛋白(cTnI)水平及丙二醛(MDA)活性的变化。结果:A、C、B组家兔于模型复苏成功后5 h肺湿/干比重、cTnI水平和MDA活性依次升高,差异均有统计学意义(P<0.01～P<0.05)。结论:艾司洛尔可以减轻家兔心室颤动复苏后肺水肿,对复苏后早期心脏有保护作用。

Objective ：To investigate the effect of combination of esmolol and epinephrine on pulmonary edema, the concentration of troponin（cTnI） and the activity of malondialdehyde （MDA） after cardiopulmonary resuscitation （CPR） in rabbit model. Methods： Twenty six rabbits were allocated to three groups, alternating current （AC）-fibrillation model was performed. Group A （control group, only anesthesia, ventilation, and operation performed）, Group B （0. O1 mg/kg epinephrine） and Group C （0.01 mg/kg epinephrine with O. 2mg/kg esmolol）. The ratio of lung wet-to-dry（W/D） weight was measured at 5 hours after CPR was performed,and the plasma level of cTnI and the activity of MDA were detected as well. Results：The ratio of W/D of group A ,B and C increased at the 5th hour,cTnI and MDA after CPR, the differences were significant （ P 〈 0.01 - P 〈 0.05 ）. Conclusions： Esmolol could reduce the myocardial injury and pulmonary edema in rabbit model after cardiac arrest.