摘要
目的探讨高渗高张溶液（HHS）对心肺复苏后兔脑、心肌损伤及胃粘膜灌注水平的影响。方法健康雄性兔，体重1．9～2．1kg，采用窒息的方法制备兔心跳骤停模型，窒息10rain后开始心肺复苏。自主循环恢复后，随机分为2组（n=10）：生理盐水对照组（NS组）静脉输注生理盐水4ml／kg，HHS组静脉输注7．2％氯化钠和6％羟乙基淀粉200／0．54ml／kg。于心跳骤停前测定心率、平均动脉压、冠脉灌注压、血红蛋白浓度、凝血功能指标、血清S-100蛋白、心肌肌钙蛋白I（cTnI）浓度和胃粘膜pH值（pHi）的基础值，并于自主循环恢复后30、60、120、180和240min时分别测定各项指标。结果与基础值比较，自主循环恢复后，两组血清S-100蛋白和cTnI浓度均明显升高，pHi均先降低，后逐渐升高（P〈0．01）；与Ns组比较，自主循环恢复后，HHS组血清S-100蛋白和cTnI浓度降低，pHi升高（P〈0．01）。结论HHS可在一定程度上减轻心肺复苏后兔的脑及心肌损伤，改善胃粘膜的微循环灌注，从而有益于改善预后。
Objective To investigate the effects of hypertonic-hyperoncotic solution （HHS） given immediately after cardiopulmonary resuscitation （CPR） on myocardial and brain injury and gastric mucosal microcirculation. Methods Twenty male rabbits weighing 1.9-2.1 kg were randomly divided into 2 groups （ n = 10 each）： control group and HHS group. The animals were anesthetized with chloral hydrate 300 mg/kg iv, tracheotomized, intubated and mechanically ventilated （FiO2 40%, VT 10 ml/kg, RR 20 bpm）. Femoral artery and vein were connulated for BP monitoring, blood gas analysis and fluid administration. Internal jugular, vein was cannulated for CVP monitoring. ECG was continuously monitored. Gastric intramucosal pH, blood coagulation and serum S-100 and cTnI concentrations were measured before （baseline） and at 30, 60, 120, 180 and 240 min after return of spontaneous circulation （ROSC）. Cardiac arrest was induced by occlusion of tracheal tube and confirmed by ECG （asystole, ventricular fibrillation） and sudden sharp drop in BP. After being suffocated for 10 min, basic life support （BLS） and advanced cardiac life support （ACLS） were started. Upon ROSC the animals received 4 ml/kg of normal saline （NS） or 7.2% NaCl ＋ 10% hydroxyethyl starch 200/0.5 （HHS） .Results The serum levels of cTnI and S-100 were significantly increased after ROSC as compared with baseline in both groups and were significantly lower in HHS group than in control group. The gastric intramucosal pH was significantly decreased after ROSC in both groups and was significantly higher in HHS group than in control group. Conclusion HHS given immediately after ROSC can ameliorate ischemia-reperfusion injury to heart and brain and improve gastric intramucosal microcirculatory perfusiou.
出处
《中华麻醉学杂志》
CAS
CSCD
北大核心
2009年第11期1026-1029,共4页
Chinese Journal of Anesthesiology
基金
湖北省科技攻关计划资助项目（NO.2004AA301C12）
关键词
盐水
高渗
羟乙基淀粉
心肺复苏术
S100蛋白质类
肌钙蛋白I
氢离子浓度
Saline solution, hypertonic
Hetastarch
Cardiopulmonary resuscitation
S100 proteins
Troponin I
Hydrogen-ion concentration
