硫化氢对心跳骤停兔心肺复苏术后脑氧代谢和糖代谢的影响

Effects of hydrogen sulfide on cerebral oxygen and glucose metabolism after cardiopulmonary resustation in cardiac arrest rabbits

目的探讨硫化氢（H2S）对心跳骤停兔心肺复苏术后脑氧代谢和糖代谢的影响。方法健康雄性日本大白兔30只，体重2．5～3．0kg，采用随机数字表法，将其随机分为3组（n=10）：假手术组（S组）、心肺复苏组（CPR组）和H1s组。采用窒息法制备心跳骤停模型，心肺复苏自主循环恢复时，CPR组或H^S组分别吸入30％氧气或含有0．008％H，S的30％氧气60min。于模型制备前5min（T0）、自主循环恢复后30min（T1）、60min（R）时，分别经颈动脉和颈静脉采集血样，进行血气分析，测定血糖及血浆H2s浓度，计算脑氧摄取率（CERO2）、颈动脉-静脉血糖差（Da-jv BG），采用ELISA法测定颈动脉血浆乳酸（Lac）浓度。于自主循环恢复后60min时处死动物，取海马组织，采用免疫组化法检测海马活化的caspase-3表达水平。结果与S组比较，CPR组和H2S组T1,2时血浆H2S浓度和CERO2升高，L时Da-jv BG升高，海马活化的caspase-3表达上调，CPR组T1-2时Lac升高，H2s组E时Lac升高（P〈0．05）；与CPR组比较，H2s组L1-2时血浆H2S浓度升高和Lac浓度降低，L时CERO2升高，Da-jv BG降低，海马活化的caspase-3表达下调（P〈0．05）。结论H2S可促进心跳骤停兔心肺复苏术后有氧代谢和葡萄糖摄取，抑制神经细胞凋亡，有利于改善神经功能。

Objective To investigate the effects of hydrogen sulfide （H2S） on cerebral oxygen and glu- cose metabolism after cardiopulmonary resuscitation in cardiac arrest rabbits. Methods Thirty healthy male Japa- nese white rabbits weighing 2.5-3.0 kg were randomly divided into 3 groups（ n = 10 each） ： sham operation group （group S）, cardiac arrest-cardiopulmonary resuscitation group （group CPR） and H2S group. The animals were anesthetized with inhalation of 5 % halothane, trachea was exposed and intubated. Cardiac arrest was produced by asphyxia and cardiopuhnonary resuscitation was performed 8 min after asphyxia. Immediately after return of spontaueous circulation （ROSC）, 30% 02 or 30% 0,. containing 0.008% H：S was inhaled in CPR and H：S groups respectively. Blood samples were taken from carotid artery and internal jugular vein respectively at 5 min before cardiac arrest （T0 ） ,30 min（T1） and 60 min（T2 ） after ROSC for blood gas analysis, and cerebral oxygen extraction rate（CERO; ）, arterio-jugular venous difference of blood glucose （Da-jv BG） were calculated. Carotid artery plasma lactate（Lac） concentration was determined by ELISA. The animals were sacrificed at 60 min after ROSC, and their brains were removed and hippocampi were isolated tbr determination of activated caspase-3 expression. Results Compared with group S, the plasma H2 S concentration and CERO2 were significantly increased at T1,2 Da-jv BG was increased at T1 , and activated caspase-3 expression was up-regulated in CPR and Hz S groups and plasma Lac concentration was increased at T, ,2 in group CPR, and at T1 in group H2 S （ P 〈 0.05）. Compared with group CPR, the plasma H2 S concentration was significantly increased and plasma Lac concentration decreased at T1,2 , CERO2 increased and Da-jv BG decreased at T, , and activated caspase-3 expression down-regulated in H2 S group （ P 〈 0.05）. Conclusion FI2 S can increase oxygen metabolism and glucose uptake, and inhibit apoptosis which is help-ful for improving neural function in cardiac arrest rabbits after cardiopulmonary resuscitation.