山莨菪碱对心脏骤停患者氧化应激及心肺复苏效果的影响

Effects of anisodamine on oxidative stress and cardiopulmonary resuscitation in patients with cardiac arrest

目的:探讨山莨菪碱对心脏骤停患者氧化应激及心肺复苏效果的影响。方法:选择急诊科抢救的心脏骤停患者119例,骤停时间≤10min,随机分为对照组和干预组。两组均按照美国心脏学会心肺复苏指南进行标准的心肺复苏,干预组在标准心肺复苏基础上静脉注射山莨菪碱,比较两组患者自主循环恢复(ROSC)率及复苏后24h存活率;分别在自主循环恢复后和复苏24h后测定血清总超氧化物岐化酶(T-SOD)活力、总抗氧化力(T-AOC)和丙二醛(MDA)含量,比较两组间差别。结果:干预组患者自主循环恢复率与对照组比较差异无统计学意义(P>0.01);复苏24h后,干预组患者存活率显著高于对照组(P<0.01);自主循环恢复后及复苏24h后,干预组T-SOD活力和T-AOC显著高于对照组,MDA含量显著低于对照组(P<0.01)。结论:早期应用山莨菪碱可能会减轻心脏骤停患者体内氧化应激,可能有助于提高复苏后24h存活率,但对于短期自主循环的恢复可能没有明显改善。

Objective：To explore the effects of anisodamine on oxidative stress and cardiopulmonary resuscita- tion （CPR） in emergency patients with cardiac arrest. Method： 119 emergency patients who suffered cardiac arrest within 10 min were selected and randomly divided into control group and intervention group. Standard CPR ac- cording to AHA guidelines were practiced immediately in both groups. Moreover, patients in intervention group were additionally intervened with anisodamine in vein. ROSC rate and 24 h survival rate after CPR were observed and serum malondialdehyde （MDA） contents, total superoxide dismutase （T-SOD） activities and total anti--oxi- dation capacity （T AOC） were compared between the two groups. Result： No differences on ROSC rate were found between the two groups （P〉0.01）. However, the 24h survival rate in intervention group was significantly higher than that in control group （P〈0.01）. T-SOD activities and T-AOC were higher and MDA contents were lower after ROSC and 24 h later in intervention group than those in control group （P〈0.01）. Conclusion：Early use of anisodamine may protect against the damage of oxidative stress after cardiac arrest and improve the 24 h survival rate after CPR, but may not be helpful to ROSC.