【摘要】：目的研究采用α-去甲基腎上腺素(α-MNE)、K-阿片受體激動(dòng)劑U50488H、瑞芬太尼及治療性低溫的集束化療法對家兔心臟驟停后綜合征早期心、腦功能及血流動(dòng)力學(xué)優(yōu)化作用,探索二氫辣椒素(DHC)藥物誘導(dǎo)治療性低溫可行性及其可能作用機(jī)制。 方法50只健康成年家兔麻醉置管前隨機(jī)(隨機(jī)數(shù)字法)分為5組(n=10)：手術(shù)對照組(A組)、腎上腺素(E)組(B組)、α-MNE+U50488H組(C組)、α-MNE+U50488H+治療性低溫+瑞芬太尼組(D組)、α-MNE+U50488H+DHC+瑞芬太尼組(E組)。體外電擊建立家兔心肺復(fù)蘇模型,于誘發(fā)室顫前15min、復(fù)蘇后30min、60min、120min、240min、360min動(dòng)態(tài)監(jiān)測血流動(dòng)力學(xué)指標(biāo),檢測血清肌鈣蛋白(cTnl)、神經(jīng)元特異性烯醇化酶(NSE)濃度變化。統(tǒng)計(jì)學(xué)處理采用方差分析。 結(jié)果(1)復(fù)蘇后,除A組外,其余4組家兔MAP、peak±dp/dt均不同程度下降,LVEDP均不同程度升高(P均0.05)；D、E組家兔各時(shí)間點(diǎn)參數(shù)無明顯差異(P均0.05)；D、E組與B組相比,MAP于60min后各時(shí)間點(diǎn)差異有統(tǒng)計(jì)學(xué)意義(P0.05),peak±dp/dt、LVEDP在復(fù)蘇成功后30mmin后各時(shí)間點(diǎn)差異有統(tǒng)計(jì)學(xué)意義(P0.05)；D、E組與C組相比,MAP、peak±p/dt及LVEDP于60min后各時(shí)間點(diǎn)差異有統(tǒng)計(jì)學(xué)意義(P0.05)。(2)復(fù)蘇后,除A組外,其余4組家兔cTnl、NSF濃度均不同程度升高(P均0.05)；D、E組家兔各時(shí)間點(diǎn)各指標(biāo)濃度仍無明顯差異(P均0.05)；D、E組與B組相比,cTnl、NSF濃度在復(fù)蘇后各時(shí)間點(diǎn)差異均有統(tǒng)計(jì)學(xué)意義(P0.05)；D、E組與C組相比,cTnl、NSF質(zhì)量濃度于60mmin后各時(shí)間點(diǎn)值差異有意義(P0.05)。(3)D組家兔體表降溫至復(fù)蘇后60min肛溫平均降低5.9℃,E組家兔DHC (1.0mg·kg-1·h-1)藥物誘導(dǎo)至復(fù)蘇后60mmin肛溫平均降低6.0℃,均達(dá)到治療性低溫降溫目標(biāo),無統(tǒng)計(jì)學(xué)差異(P0.05)。 結(jié)論DHC靜脈滴注可快速、有效誘導(dǎo)治療性低溫,α-MNE、U50488H、瑞芬太尼及治療性低溫的集束化療法可有效改善心臟驟停后綜合征。
[Abstract]:Objective to study the effects of 偽 -noradrenaline (偽-MNE), K- opioid receptor agonist U50488H, remifentanil and therapeutic hypothermia) on early cardiac, cerebral function and hemodynamics in rabbits with cardiac arrest syndrome. To explore the feasibility and possible mechanism of dihydrocapsaicin (DHC) induced hypothermia. Methods Fifty healthy adult rabbits were randomly divided into 5 groups (n = 10): operation control group (group A), epinephrine (E) group (group B) and 偽 MNE U50488H group (group C). 偽-MNE U50488H therapeutic remifentanil group (group D) and 偽-MNE U50488H DHC remifentanil group (group E). Rabbit cardiopulmonary resuscitation model was established by electric shock in vitro. The hemodynamic indexes were dynamically monitored at 30 min, 60 min, 120 min and 360 min after ventricular fibrillation, and the changes of serum troponin (cTnl), neuron-specific enolase (NSE) concentration were detected. ANOVA was used for statistical analysis. Results (1) after resuscitation, the MAP,peak 鹵dp/dt decreased in different degree and LVEDP increased in different degree in the other four groups except group A, and there was no significant difference in the parameters of each time point in group E (P 0.05). Compared with group B, MAP in group E was significantly different at each time point after 60min (P0.05), peak 鹵dp/dt,LVEDP after successful resuscitation) (P0.05). Compared with group C, MAP,peak 鹵p/dt and LVEDP were significantly different at each time point after 60min resuscitation (P0.05). (2). The cTnl,NSF concentrations of the other four groups were increased in different degrees except group A (P0.05). There was no significant difference in the concentration of cTnl,NSF between group E and group B at each time point (P0.05), but there was significant difference between group E and group B at each time point after resuscitation (P0.05). Compared with group C, the concentration of cTnl,NSF in group D was significantly lower than that in group C (P0.05). (3). The anus temperature of 60min in group D was decreased by 5.9 鈩，

本文編號：2427660