乌司他丁对兔心肺复苏后早期脑氧代谢的影响

Effect of ulinastatin on early oxygen metabolism in cardiopulmonary resuscitation rabbits

目的探讨乌司他丁对兔心肺复苏（CPR）后早期脑氧代谢的影响。方法建立30只大白兔CPR模型，采用随机数字表法将其分入手术对照组、CPR组、乌司他丁组，每组10只。手术对照组行气管插管和股动、静脉穿刺留置穿刺管，CPR组行常规CPR，乌司他丁组在进行常规CPR的基础上静脉注射乌司他丁5×10^4U／kg。分别于CPR稳定后0、1、2、4h测定大白兔颈内静脉氧饱和度（SjvO2）、颈静脉球部血氧分压（PjvO2）、动脉乳酸（aLac）、颈内静脉球乳酸（jvLac），计算动脉血氧含量（CaO2）、颈内静脉球血氧含量（CjvO2）、动脉与颈内静脉血氧含量之差（Ca-jvO2）、脑氧摄取率（CERO2）、乳酸生成率（LacPR）和乳酸氧指数（LOI）。结果CPR组在CPR稳定后4h的CaO2和CPR稳定后2、4h的CjvO2分别显著低于同组CPR稳定后0h（P值均〈0．05）；乌司他丁组在CPR稳定后4h的SjvO2和PjvO2，在CPR稳定后2、4h的CaO2和CERO2，以及在CPR稳定后1、2、4h的CjvO2分别显著低于同组CPR稳定后0h（P值分别〈0．05、0．01）。乌司他丁组在CPR稳定后2、4h的SjvO2、PjvO2和CERO2，以及在CPR稳定后4h的CaO2、CjvO2分别显著低于手术对照组和CPR组同时间点（P值分别〈0．05、0．01）。CPR组在CPR稳定后4h的aLac、jvLac分别显著高于同组CPR稳定后0h（P值均〈0．05）；乌司他丁组在CPR稳定后2、4h的aLac和jvLac分别显著高于同组CPR稳定后0h（P值分别〈0．05、0．01）。乌司他丁组在CPR稳定后2、4h的aLac和CPR稳定后4h的jvLac分别显著低于手术对照组和CPR组同时间点（P值均〈0．05）。结论乌司他丁能够改善兔CPR后早期脑氧代谢异常。

Objective To explore the effect of ulinastatin on early oxygen metabolism in cardiopulmonary resuscitation （CPR） rabbit models. Methods Thirty CPR rabbits were randomly divided into 3 groups （n = 10） = operation group, CPR group and ulinastatin group. The rabbits in the operation group were treated with endotracheal intubation, femoral arteriovenous puncture, and indwelling puncture tube. The rabbits in the CPR group were only treated with traditional CPR. The rabbits in the ulinastatin group were treated with CRP and intravenously given ulinastatin 5 × 10^4 U/kg. The jugular venous oxygen saturation （Sjv O2 ）, jugular vein ball ministry blood oxygen partial pressure （pjvO2）, artery lactic acid （aLac） and internal jugular vein ball lactic acid （jvLac） were determined at 0, 1, 2 and 4 h after CPR. The arterial oxygen content （CaO2）, internal jugular vein ball blood oxygen content （CjvO2）, arterial blood oxygen content and internal jugular venous blood oxygen content （Ca-jvO2）, brain oxygen uptake （CERO2）, lactic acid production rate （LacPR） and lactic acid oxygen index （LOI） were calculated and analyzed. Results CaO2 at 4 h and CjvO2 at 2 h and 4 h after CPR were significantly lower than those at 0 h in the CPR group （all P〈0.05）. SjvO2 and pjvO2 at 4 h, CaO2 and CERO2 at 2 h and 4 h, and CjvO2 at 1 h, 2 h and 4 h after CPR were significantly lower than those at. 0 h in the ulinastatin group （P〈0.05 or 0.01）. SjvO2, pjvO2 and CERO2 at 2 h and 4 h and CaO2 and CjvO2 at 4 h after CPR in the ulinastatin group were significantly lower than those in the control group and CPR group （P〈0.05 or 0.01）. aLac and jvLac at 4 h after CPR were significantly higher than those at 0 h in the CPR group （both P,〈0.05）. aLac and jvLac at 2 h and 4 h after CPR were significantly higher than those at 0 h in the ulinastatin group （P〈0.05 or 0.01 ）. aLac at 2 h and4 h and jvLac at 4 h after CPR in the ulinastatin group were significantly lower than those at the same time point in the control group and CPR group （all P 〈 0. 05）. Conclusion Ulinastatin can improve the unusual oxygen metabolism followed by CPR in rabbits.