参附注射液在防治大鼠心肺复苏后心功能不全中作用机制的研究

The study of the mechanism of cardiac dysfunction in the heart recovery of rats was controlled by Shenfu Injection

目的:探讨参附注射液对心肺复苏后大鼠心肌重建的影响及机制。方法:60只Wistar大鼠制备心跳骤停-心肺复苏模型,随机分为假手术组、对照组和参附注射液组,每组20只,假手术组不经历心肺复苏,对照组行常规复苏后静脉注射0.9%氯化钠溶液,参附注射液组行常规复苏后静脉注射20.00ml/kg参附注射液。动态观察3组大鼠左室舒张末压(LVEDP)、左室内压上升和下降速率(±dp/dt)、血清心肌酶学指标[肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)]及肿瘤坏死因子α(TNF-α)的变化,ELISA法检测血清中丙二醛(MDA)、超氧化物歧化酶(SOD)、黄嘌呤氧化酶。结果:心肺复苏后2h、4h,参附注射液组LVEDP下降,与对照组对比差异有统计学意义(P<0.05),参附注射液组±dp/dt不同程度呈显著升高,与对照组对比差异有统计学意义(P<0.05)。与假手术组对比,对照组、参附注射液组的CK、CK-MB、TNF-α、SOD呈显著性增高(P<0.01),MDA、黄嘌呤氧化酶呈显著性下降(P<0.01),与对照组对比,参附注射液组CK、CK-MB、TNF-α呈显著性下降,SOD呈显著性增高(P<0.05),MDA、黄嘌呤氧化酶呈显著性下降(P<0.05)。结论:参附注射液可以改善心肺复苏后心功能不全症状,其机制与降低氧化应激反应、改善对脏器的损伤有关。

Objective：To explore the effect of Shenfu injection on rat myocardial reconstruction after cardiopulmonary resuscitation（CPR）and the mechanism.Method：Preparation of 60 Wistar rats cardiac arrest-CPR model,were randomly divided into control group,saline group and shenfu injection group,with 20 in each group.The control group only suffered surgery operation,the physiological saline group suffered routine recovery,and attached to the line of conventional recovery after intravenous injection group had 20.00 ml/kg-shenfu injection.Then we dynamically observed the left ventricular end-diastolic pressure（LVEDP）,left ventricular pressure rising and falling rate（＋ dp/dt）,serum myocardial enzymes（CK,CK-MB）and TNF-αchanges.ELISA method was used to detect the serum MDA,SOD,xanthine oxidase.Result：CPR after 2,4 h,Compared with normal saline group LVEDP in shenfu injection group decreased,,and the difference was statistically significant（P0.05）.Compared with normal saline group,the＋dp/dt in shenfu injection group was significantly increased in different level,and the difference was statistically significant（P0.05）.Compared with control group,CK,CK-MB,TNF-α,SOD in saline group and shenfu injection group were significantly increased（P0.01）.Compared with normal saline group malondialdehyde,xanthine oxidase were significantly decreased（P0.01）,CK,CK-MB,TNF-αin shenfu injection group were significantly decreased,SOD was significantly increased（P0.05）,malondialdehyde,xanthine oxidase were significantly decreased（P0.05）.Conclusion：Shenfu injection can reduce oxidative stress reaction and the viscera damage,which protect the heart function.