肾上腺素联合艾司洛尔改善兔心肺复苏后肺水肿的研究

Esmolol with epinephrine improves pulmonary edema after cardiopulmonary resuscitation in Rabbit

目的:通过制备兔窒息心肺复苏模型,研究联合应用肾上腺素和艾司洛尔对心肺复苏中的肺保护和心肌损伤的保护。方法:30只日本大耳白兔随机分为三组:手术对照组6例;肾上腺素组12例(0.02mg/kg肾上腺素)以及肾上腺素联合艾司洛尔组12例(0.02mg/kg肾上腺素+0.5mg/kg艾司洛尔)。麻醉后,气管切开,窒息诱导心脏骤停,制备心肺复苏模型。分别在窒息前和复苏后240min测量肺的干湿比、肌钙蛋白I以及血细胞比容以及评估肺的损伤和心脏的损伤,并观察肺组织的病理变化。结果:两组生存率无显著差异。肺的湿干比在肾上腺素组和联合应用组分别为(6.1±1.15)、(4.5±0.78),P<0.01。血细胞比容在肾上腺素组明显高于联合应用组(11.3±2.9)%、(6.6±3.7)%,P<0.01。肌钙蛋白I在联合用药组(0.51±0.13)显著低于肾上腺素组(0.74±0.12)(P<0.01)。结论:在CPR中联合应用肾上腺素和艾司洛尔可以防止肺水肿的发生和防止血细胞比容的增加,同时降低心肌损伤。

Objective： To investigate the effect of combination of esmolol and epinephrine on pulmonary and cardiac injury following CPR in asphyxia Rabbit CPR model. Method：Thirty Japanese White Rabbit were randomized into three groups：sham operation group（Group-C,n=6） ,epinephrine group（ Group-E：0.02 mg/kg epinephrine,n= 12） and epinephine ＆ esmolol group （Group-E＋E：0.02 mg/kg epinephrine with 0.5 mg/kg esmolol,n= 12）. Under anesthesia, after tracheotomy, cardiac arrest was induced by asphyxia. The lung wet-to-dry （W/D） weight ratio and the hematocrit（Hct） difference before and after CPR （Hct-D） 240 rain were detected. The plasma levels of troponin-I （T-I） were measured to evaluate the degree of cardiac injury. The pathological changes of lung tissue were observed. Result：There was no differences in survival between two groups. The lung W/D weight ratio in Group-E（6.1±1.15,meaniSD） was significant higher than that for Gronp-E＋E（4.5±0.78,P〈0.01）. Hct- D was significant higher in Group-E（11. 3±2.9%） than in Group-E＋E （6.6±3.7± ,P〈0.01）. The plasma level of Troponin-I in Group-E＋E（0.51±0.13） was significant lower than for Group E（0. 74±0.12） （P〈0.01）. Con- clusion：The use of esmolol during CPR with epinephrine can prevented the development of pulmonary edema,increase in Het and also improve cardiac injury during and after CPR.