文献类型：期刊文献

中文题名：不同浓度米伐西醇对家兔心脏骤停后综合征不同时相心脑损伤的保护作用研究

英文题名：Study on the Protective Effects of Different Densities of Mivazerol on Heart-Brain Injury of Rabbits with Post-cardiac Arrest Syndrome at Different Phases

作者：邵向阳[1];张志明[2];雍文兴[2];李娟[2];王涛[1];梁艳[1];张卫强[1];颉志英[1]

第一作者：邵向阳

机构：[1]甘肃中医药大学,甘肃兰州730000;[2]甘肃中医药大学附属医院,甘肃兰州730000

第一机构：甘肃中医药大学

年份：2020

卷号：33

期号：8

起止页码：16

中文期刊名：西部中医药

外文期刊名：Western Journal of Traditional Chinese Medicine

收录：CSTPCD

基金：甘肃省卫生行业科研计划项目(GSWSKY-2014-35)。

语种：中文

中文关键词：心脑损伤;心脏骤停后综合征;米伐西醇

外文关键词：heart-brain injury;post-cardiac arrest syndrome;mivazerol

摘要：目的:探讨不同浓度米伐西醇对家兔心脏骤停后综合征(PCAS)不同时相心脑损伤的保护作用。方法:将40只成年健康家兔随机分为4组,PCAS模型组(A组)、米伐西醇低剂量组(25μg/kg,B组)、米伐西醇中剂量组(37.5μg/kg,C组)、米伐西醇高剂量组(50μg/kg,D组)。建立家兔心肺复苏模型,于诱发室颤前15分钟,复苏后30、60、120、240分钟监测并记录血流动力学指标,包括左室内压上升最大速率(peak+dp/dt)、左室内压下降最大速率(peak-dp/dt)、平均动脉血压(MAP)、左室舒张末期压力(LVEDP),并留取动脉血,采用酶联免疫吸附法(ELISA)检测心肌肌钙蛋白I(cTnI)、神经元特异性烯醇化酶(NSE)、S100β蛋白(S100β)的浓度。结果:复苏前4组家兔血流动力学指标MAP、peak+dp/dt、peak-dp/dt、LVEDP和血清心脑损害标志物cTnI、NSE、S100β差异无统计学意义(P>0.05)。复苏后4组家兔MAP、peak+dp/dt、peak-dp/dt均不同程度下降,LVEDP均不同程度升高(P<0.05),差异有统计学意义。与A组相比,B、C、D组家兔MAP于复苏后60分钟后各时间点差异有统计学意义(P<0.05),D组差异更显著(P<0.01)。与A组相比,B组peak+dp/dt、peak-dp/dt、LVEDP在复苏后60分钟后各时间点差异有统计学意义(P<0.05)。与A组相比,C组LVEDP在复苏后30、60分钟各时间点差异有统计学意义(P<0.05),120、240分钟各时间点差异有统计学意义(P<0.01);peak+dp/dt在复苏后30、60、120分钟各时间点差异有统计学意义(P<0.05),240分钟时间点差异有统计学意义(P<0.01);peak-dp/dt在复苏后30、60、240分钟各时间点差异有统计学意义(P<0.05),120分钟时间点差异有统计学意义(P<0.01)。与A组相比,D组peak+dp/dt、peak-dp/dt、LVEDP在复苏后30min后各时间点差异有统计学意义(P<0.01)。复苏后4组家兔血清cTnI、NSE、S100β均不同程度升高差异有统计学意义(P<0.05)。与A组相比,B、C组家兔cTnI、NSE、S100β在复苏后各时间点差异有统计学意义(P<0.05)。与A组相比,D组家兔cTnI、NSE、S100β在复苏后各时间点差异有统计学意义(P<0.01)。结论:米伐西醇不同剂量组均可改善复苏后家兔血流动力学指标,减少复苏后心脑损害标志物cTnI、NSE、S100β的释放,能有效减轻心脏骤停后心脑功能损伤,对心脏骤停后综合征中心脑损伤有保护作用,其中50μg/kg米伐西醇对心脏骤停后综合征中心脑损伤的保护作用最明显。
Objective: To investigate the protective effects of different densities of mivazerol on heart-brain injury of rabbits with post-cardiac arrest syndrome(PCAS) at different phases. Methods: Forty rabbits were randomized into four groups: PCAS model group(A group), low(25 μg/kg, B group), moderate(37.5 μg/kg, C group) and high(50 μg/kg, D group) doses groups of mivazerol, rabbit model with cardio-pulmonary resuscitation was prepared, hemodynamic indexes were monitored 15 minutes before inducing ventricular fibrillation, 30 minutes,60 minutes, 120 minutes and 240 minutes after resuscitation, including maximum rate of left ventricular pressure rise(peak+dp/dt), maximum rate of left ventricular pressure decline(peak-dp/dt), mean arterial blood pressure(MAP)and left ventricular end-diastolic pressure(LVEDP), arterial blood was taken, and ELISA method was used to detect the concentrations of cardiac troponin(cTn1), neuronspecific enolase(NSE) and S100 β protein(S100 β). Results:The difference had no statistical meaning in hemodynamic indexes including MAP, peak+dp/dt, peak-dp/dt, LVEDP and heart-brain injury markers including cTn1, NSE and S100 β among four groups before resuscitation(P>0.05).MAP, peak+dp/dt and peak-dp/dt in four groups after resuscitation reduced in different degrees, LVEDP rose in different extents(P <0.05), and the difference could be found. Compared with A group, the difference could be found in MAP of B, C and D 60 minutes after resuscitation(P<0.05), the difference was more notable in D group(P<0.01),compared with A group, the difference could be found in peak+dp/dt, peak-dp/dt and LVEDP in B group 60 minutes after resuscitation(P<0.05). Compared with A group, the difference had statistical meaning in LVEDP of C group30 minutes ad 60 minutes after resuscitation(P<0.05), the difference presented statistical meaning in 120 minutes and 240 minutes(P<0.01), the difference could be found in peak+dp/dt 30, 60 and 120 minutes after resuscitation(P <0.05), the difference could be found in 240 minutes(P <0.01);the difference showed statistical meaning in peak-dp/dt 30, 60 and 240 minutes after resuscitation(P <0.05), the difference had statistical meaning in 120 minutes(P<0.01). Compared with A group, the difference could be found in peak+dp/dt, peak-dp/dt and LVEDP of D group 30 minutes after resuscitation at different times(P<0.01). After resuscitation, cTn1, NSE and S100 β rose to different degrees in four groups, and the difference showed statistical meaning(P<0.05). Compared with A group,the difference showed statistical meaning in cTn1, NSE and S100 β of B and C at different times after resuscitation(P<0.05). Compared with A group, the difference was statistically significant in cTn1, NSE and S100 β of D group(P <0.01). Conclusion: Different dosages of mivazerol could improve hemodynamic indexes of the rabbits after resuscitation, reduce the release of heart-brain injury markers including cTn1, NSE and S100 β after resuscitation, it could effectively relieve post-cardiac arrest heart-brain injury, protect PCAS heart-brain injury, among them, 50μg/kg mivazerol shows notable protection effects on heart-brain injury of PCAS.