氢溴酸山莨菪碱对心脏骤停行心肺复苏患者微循环及冠状动脉内皮功能的影响

Effects of anisodamine hydrobromide on microcirculation and coronary endothelial function in patients undergoing cardiopulmonary resuscitation for cardiac arrest

目的 研究氢溴酸山莨菪碱对心脏骤停行心肺复苏患者微循环及冠状动脉内皮功能的影响。方法 选取河北北方学院附属第一医院2018年5月—2021年1月收治的186例心脏骤停行心肺复苏患者作为研究对象,采用随机数字表法分为试验组(n=93)和对照组(n=93)。对照组在心肺复苏时给予常规治疗方案,试验组在此基础上给予氢溴酸山莨菪碱。对比两组患者复苏前和复苏24 h后微循环、冠状动脉内皮功能水平、血气指标;对比两组患者复苏后1、3 d格拉斯哥昏迷评分。结果 复苏24 h后,两组患者输入枝管径和输出枝管径较复苏前均升高,且相比于对照组,试验组显著更高(均P<0.05);复苏24 h后,两组患者较复苏前NO均升高,ET-1均降低,且相比于对照组,试验组NO显著更高,ET-1显著更低(均P<0.05);复苏24 h后,两组患者较复苏前SCVO2均升高,BL均降低,且相比于对照组,试验组SCVO2显著更高,BL显著更低(均P<0.05);复苏后3 d,两组患者GCS均升高,且相比于对照组,试验组GCS显著更高(P<0.05)。结论 氢溴酸山莨菪碱能够有效改善心脏骤停行心肺复苏患者的微循环、冠状动脉内皮功能、血气指标以及认知功能,疗效较高。

Objective To study the effects of anisodamine hydrobromide on microcirculation and coronary endothelial function in patients with cardiac arrest undergoing cardiopulmonary resuscitation.Methods A total of 186 patients with cardiac arrest undergoing cardiopulmonary resuscitation in our hospital from May 2018 to January 2021 were enrolled,and divided into two groups by random number table methods,each with 93 cases.Control group received conventional cardiopulmonary resuscitation,based on this,experimental group receivedanisodamine hydrobromide.Microcirculation,coronary endothelial function and blood gas parameters were compared between the two groups before and after resuscitation.Glasgow Coma Scale(GCS) score at 1 and 3 d after resuscitation was also compared between the groups.Results At 24 h after resuscitation,the diameters of afferent and efferent arterioles were significantly increased in both groups,and the range of increase was significantly larger in experimental group than in control group(P<0.05).At 24 h after resuscitation,an increase in nitric oxide(NO) level and a decrease in endothelin-1(ET-1) level were observed in both groups,meantime,experimental group had significantly higher NO level and lower ET-1 level than those of control group(P<0.05).At 24 h after resuscitation,an increase in central venous oxygen saturation(SCVO2) value and a decrease in blood lactic acid(BL) value were observed in both groups,meantime,experimental group had significantly higher SCVO2value and lower BL value than those of control group(P<0.05).At 3 d after resuscitation,an increase in GCS score was observed in both groups,meantime,experimental group had significantly higher GCS score than that of control group(P<0.05).Conclusion Anisodamine hydrobromide effectively improves the microcirculation,coronary endothelial function,blood gas parameters and cognitive function in cardiac arrestpatientsundergoing cardiopulmonary resuscitation.