本文選題：心肺復(fù)蘇術(shù) + 硫化氫��； 參考：《臨床麻醉學(xué)雜志》2015年07期

【摘要】：目的探討外源性硫化氫(H2S)對(duì)心跳驟停復(fù)蘇大鼠腦組織炎癥反應(yīng)及生存率的影響。方法健康雄性SD大鼠90只,體重260~280g。按隨機(jī)原則分為三組:對(duì)照組(Sham組,n=20):吸入麻醉藥物誘導(dǎo),氣管插管,動(dòng)靜脈置管,但不進(jìn)行心跳驟停及復(fù)蘇操作。其余大鼠經(jīng)氣管插管后進(jìn)行窒息性心跳驟停并復(fù)蘇,自主循環(huán)恢復(fù)(ROSC)后隨機(jī)分為兩組:心跳驟停復(fù)蘇組(CA組,n=35)、H2S組(n=35)。H2S組大鼠復(fù)蘇恢復(fù)自主循環(huán)(ROSC)后立即吸入80ppm H2S 60min。每組取15只大鼠,于ROSC后(sham組麻醉后)3、24和72h時(shí)斷頭取腦組織,測(cè)定腦組織中白細(xì)胞介素10(IL-10)、白細(xì)胞介素1β(IL-1β)、腫瘤壞死因子α(TNF-α)及髓過氧化物酶(MPO)的含量。采用膠帶移除實(shí)驗(yàn)評(píng)估大鼠ROSC后第14d的神經(jīng)功能。記錄ROSC后14d內(nèi)3組大鼠的存活數(shù)量,隨后斷頭取腦,計(jì)數(shù)海馬CA1區(qū)存活神經(jīng)元個(gè)數(shù)。結(jié)果 ROSC后3h時(shí)H2S組IL-10表達(dá)量明顯高于Sham和CA組(P0.05);CA和H2S組在ROSC后24h時(shí)腦組織IL-1β表達(dá)量,ROSC后3、24h時(shí)腦組織TNF-α表達(dá)量明顯高于Sham組,且CA組明顯高于H2S組(P0.05);ROSC后72h時(shí)CA組MPO活性明顯高于Sham組和H2S組(P0.05)。CA組及H2S組存活神經(jīng)元數(shù)量明顯少于Sham組,且CA組明顯少于H2S組(P0.05)。ROSC后14dSham和H2S組存活率明顯高于CA組(P0.05)。結(jié)論大鼠心跳驟停復(fù)蘇后早期吸入外源性80ppm H2S可提高心肺復(fù)蘇后14d生存率,其機(jī)制可能與抑制腦組織炎癥反應(yīng),改善海馬CA1區(qū)神經(jīng)元存活有關(guān)。
[Abstract]:Objective to investigate the effects of exogenous hydrogen sulfide (H _ 2S) on the inflammatory response and survival rate of brain tissue in rats with cardiac arrest resuscitation. Methods 90 healthy male Sprague-Dawley rats weighing 260 ~ 280 g. They were randomly divided into three groups: control group (Sham group): inhaled anesthetic induction, tracheal intubation, arteriovenous catheterization, but no cardiac arrest and resuscitation. The rest rats were randomly divided into two groups after asphyxiating cardiac arrest and resuscitation after tracheal intubation. After spontaneous circulation was recovered, the rats in the cardiac arrest and resuscitation group were randomly divided into two groups: the CA group, the CA group and the H2S group. The rats in the H2S group were inhaled 80ppm H2S for 60 mins immediately after resuscitation and recovery of autonomic circulation. Brain tissue was taken from 15 rats in each group at 24 and 72 hours after anesthesia in sham group after ROSC. The contents of interleukin 10 IL-10, IL-1 尾 1 尾, TNF- 偽 and myeloperoxidase (MPO) in brain tissue were measured. The nerve function of rats was evaluated by tape removal test on day 14 after ROSC. The survival numbers of the three groups were recorded within 14 days after ROSC, and the number of surviving neurons in the hippocampal CA1 area was counted. Results the expression of IL-10 in H2S group was significantly higher than that in Sham group and CA group at 3 h after ROSC. The expression of IL-1 尾 in brain tissue in H2S group was significantly higher than that in Sham group at 24 h after ROSC. The activity of MPO in CA group was significantly higher than that in H2S group at 72 h after P0.05 roSC. The number of surviving neurons in CA group was significantly higher than that in Sham group and H2S group, and the number of surviving neurons in CA group was significantly lower than that in Sham group, and the survival rate of 14dSham and H2S group in CA group was significantly higher than that in CA group. Conclusion early inhalation of exogenous 80ppm H2S after cardiopulmonary resuscitation can improve the survival rate of 14 days after cardiopulmonary resuscitation in rats. The mechanism may be related to the inhibition of inflammation in brain tissue and the improvement of neuron survival in CA1 area of hippocampus.
【作者單位】： 哈爾濱醫(yī)科大學(xué)附屬第二醫(yī)院麻醉科黑龍江省麻醉與危重病學(xué)重點(diǎn)實(shí)驗(yàn)室黑龍江省高校麻醉基礎(chǔ)理論與應(yīng)用研究重點(diǎn)實(shí)驗(yàn)室;
【基金】：國(guó)家自然科學(xué)基金(81372026,81000822)
【分類號(hào)】：R614

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