早期集束化治疗对家兔心脏骤停后综合征心脑保护的实验研究
发布时间：2019-02-21 16:12
【摘要】：目的研究采用α-去甲基肾上腺素(α-MNE)、K-阿片受体激动剂U50488H、瑞芬太尼及治疗性低温的集束化疗法对家兔心脏骤停后综合征早期心、脑功能及血流动力学优化作用,探索二氢辣椒素(DHC)药物诱导治疗性低温可行性及其可能作用机制。 方法50只健康成年家兔麻醉置管前随机(随机数字法)分为5组(n=10)：手术对照组(A组)、肾上腺素(E)组(B组)、α-MNE+U50488H组(C组)、α-MNE+U50488H+治疗性低温+瑞芬太尼组(D组)、α-MNE+U50488H+DHC+瑞芬太尼组(E组)。体外电击建立家兔心肺复苏模型,于诱发室颤前15min、复苏后30min、60min、120min、240min、360min动态监测血流动力学指标,检测血清肌钙蛋白(cTnl)、神经元特异性烯醇化酶(NSE)浓度变化。统计学处理采用方差分析。 结果(1)复苏后,除A组外,其余4组家兔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组家兔各时间点参数无明显差异(P均0.05)；D、E组与B组相比,MAP于60min后各时间点差异有统计学意义(P0.05),peak±dp/dt、LVEDP在复苏成功后30mmin后各时间点差异有统计学意义(P0.05)；D、E组与C组相比,MAP、peak±p/dt及LVEDP于60min后各时间点差异有统计学意义(P0.05)。(2)复苏后,除A组外,其余4组家兔cTnl、NSF浓度均不同程度升高(P均0.05)；D、E组家兔各时间点各指标浓度仍无明显差异(P均0.05)；D、E组与B组相比,cTnl、NSF浓度在复苏后各时间点差异均有统计学意义(P0.05)；D、E组与C组相比,cTnl、NSF质量浓度于60mmin后各时间点值差异有意义(P0.05)。(3)D组家兔体表降温至复苏后60min肛温平均降低5.9℃,E组家兔DHC (1.0mg·kg-1·h-1)药物诱导至复苏后60mmin肛温平均降低6.0℃,均达到治疗性低温降温目标,无统计学差异(P0.05)。 结论DHC静脉滴注可快速、有效诱导治疗性低温,α-MNE、U50488H、瑞芬太尼及治疗性低温的集束化疗法可有效改善心脏骤停后综合征。
[Abstract]:Objective to study the effects of 伪 -noradrenaline (伪-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 伪 MNE U50488H group (group C). 伪-MNE U50488H therapeutic remifentanil group (group D) and 伪-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 卤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 卤dp/dt,LVEDP after successful resuscitation) (P0.05). Compared with group C, MAP,peak 卤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，
本文编号：2427660
[Abstract]:Objective to study the effects of 伪 -noradrenaline (伪-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 伪 MNE U50488H group (group C). 伪-MNE U50488H therapeutic remifentanil group (group D) and 伪-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 卤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 卤dp/dt,LVEDP after successful resuscitation) (P0.05). Compared with group C, MAP,peak 卤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，
本文编号：2427660
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