左西孟旦对心搏骤停-心肺复苏后大鼠心功能的保护作用

The protective effects of levosimendan in post resuscitation rat cardiac function

目的:通过建立大鼠心搏骤停和复苏模型,应用心脏超声技术,探讨左西孟旦对复苏后大鼠心功能的影响。方法:成年雄性SD大鼠29只,随机分为假手术组(5只),药物组(12只)和对照组(12只)。药物组和对照组用窒息法制作心脏骤停模型,并及时行心肺复苏,复苏后观察6h。药物组大鼠在心肺复苏期间及复苏后予左西孟旦干预,假手术组和对照组同时予等剂量生理盐水处理,假手术组大鼠不进行心搏骤停诱导和复苏操作,与实验组和对照组一起于复苏后1~6h采集血气和心超数据,比较各组间大鼠复苏后不同时间点心功能变化情况。结果:实验组复苏成功11只(91.7%),对照组复苏成功9只(75%),组间差异无统计学意义(P=0.590),所有复苏大鼠存活时间都达到了6h。对照组和药物大鼠在复苏后心功能均明显受损,且随着时间延长,心功能呈下降趋势。复苏后1h对照组大鼠射血分数(EF)由(77±4)%下降至(61±11)%,短轴收缩率(FS)由(40±7)%下降至(26±4)%,每搏输出量(SV)由(0.25±0.14)ml/min下降至(0.17±0.05)ml/min,心输出量(CO)由(147±19)ml/min下降至(83±25)ml/min。药物组大鼠复苏后1hEF由(78±7)%下降至(71±13)%,FS由(40±8)%下降至(38±7)%,SV由(0.34±0.14)ml/min下降至(0.25±0.04)ml/min,CO由(146±19)ml/min下降至(123±16)ml/min,对照组较药物组下降更为明显,且两组间差异有统计学意义(P<0.05)。对照组大鼠复苏后心率较假手术组变化不明显,随着时间延长,药物组大鼠心率较对照组和假手术组大鼠相比似有下降趋势,但是组间差异无统计学意义。假手术组心功能指标在6h观察期内未见明显变化。结论:在大鼠心脏骤停与复苏模型中,复苏期间及复苏后予左西孟旦治疗,能明显保护和改善大鼠心脏功能。

Objective：To study the protective effects of levosimendan in post resuscitation rat cardiac function by establishing a rat cardiac arrest and resuscitation model with the help of echocardiography.Method：Twenty-nine healthy male SD rats were randomly divided into sham group（n=5）,LEVO group（n=12）and control group（n=12）.We established cardiac arrest model in control and LEVO groups.After 6 minutes untreated cardiac arrest,cardio-pulmonary resuscitation was given.We observed 6 hours.The LEVO group was treated with levosimendan during and after CPR,while the control and sham group were given equivalent volume of saline solution.The sham group was not induced into cardiac arrest,no resuscitation as well.They were used to offer baseline data for our study,together with LEVO and control group,gas analysis and echocardiography data were recorded per hour after resuscitation at 1-6 h.Result：Eleven rats were successfully resuscitated in LEVO group（91.7%）,9 rats were successfully resuscitated in control group,there was no significant differences in success rate of resuscitation（P=0.590）.All resuscitated rats have survived 6 hours.The cardiac function has declined dramatically in both groups,and it was getting worse with time lasts.In control group,after resuscitated 1 h,the ejection fraction has decreased from（77±4）% to（61±11）%,fraction shortening has decreased from（40±7）% to（26±4）%,stroke volume has decreased from（0.25±0.14）ml/min to（0.17±0.05）ml/min,and cardiac output has decreased from（147±19）ml/min to（83±25）ml/min.However,in LEVO group,the decline was not so obvious,with ejection fraction from（78±7）%to（71±13）% fraction Shortening from（40±8）% to（38±7）%,Stroke volume from（0.34±0.14）ml/min to（25±0.04）ml/min,and cardiac output from（146±19）ml/min to（123±16）ml/min,There was significant difference between two groups.The heart rate in control group after resuscitation did not change significantly compared with sham group,（P〉0.05）.Heart rate in LEVO appeared to be lower than control and sham groups,but no statistic difference.During observation period,cardiac function had no great change in sham group.Conclusion：We find that in our rat cardiac arrest and resuscitation model,treated with levosimendan will protect and improve the cardiac function.