国际麻醉学与复苏杂志   2018, Issue (6): 3-3
    
U50,488H后处理对心搏骤停大鼠复苏早期心功能的影响
王庆祥, 蔡东妙, 聂洋洋, 赵俊林1()
1.厦门大学附属第一医院麻醉科
Effects of κ-opioid agonist U50,488H postconditioning on early cardiac function in rats undergoing cardiac resuscitation
 全文:
摘要:

目的 探讨κ-阿片受体(κ-opioid receptor, κ-OR)激动剂U50,488H后处理对心搏骤停复苏早期大鼠心功能和复苏成功率的影响。 方法 心搏骤停的SD大鼠按照以下3组的干预方式进行心肺复苏,直至复苏后2 h各组仍存活达20只为止。3组分别为手术对照组(Con组)、肾上腺素组(Epi组)和肾上腺素+U50,488H组(EU组)。Con组和Epi组于心搏骤停后复苏开始前股静脉注射0.2 ml生理盐水,而EU组股静脉注射0.2 ml U50,488H(1 mg/kg)。复苏时Con组不接受肾上腺素的复苏治疗,其余两组均接受肾上腺素(0.02 mg/kg)的复苏治疗。记录窒息前、自主循环恢复即刻以及复苏后10 min、30 min、1 h、2 h的心功能评价参数,并计算各组复苏率。 结果 Epi组和EU组复苏成功率和复苏后2 h存活率差异无统计学意义(P>0.05);Epi组和EU组自主循环恢复时间(time of spontaneous circulation recovery, Tcpr)较Con组明显缩短(P<0.05),Epi组与EU组Tcpr比较差异无统计学意义(P>0.05);Epi组和EU组在自主循环恢复即刻以及复苏后10 min、30 min、1 h时HR、MAP、左心室内压最大上升速率(maximal rate of rise in blood pressure in the ventricular chamber, dp/dtmax)、左心室内压最大下降速率(maximal rate of decline in blood pressure in the ventricular chamber, -dp/dtmax)和左心室舒张末压(left ventricular end-diastolic pressure, LVEDP)差异均无统计学意义(P>0.05),但复苏后2 h时EU组MAP、dp/dtmax和-dp/dtmax较Epi组均明显增加(P<0.05),同时EU组LVEDP较Epi组明显降低(P<0.05)。 结论 复苏早期应用肾上腺素联合1 mg/kg κ-OR激动剂U50,488H不影响大鼠的复苏成功率,且可改善复苏后2 h的左心室收缩和舒张功能。

关键词: 心搏骤停;缺血再灌注;复苏;κ-阿片受体;后处理
Abstract:

Objective To investigate the effects of κ-opioid agonist U50,488H postconditioning on early cardiac function and success rate of resuscitation in rats undergoing cardiac arrest. Methods The SD rats with cardiac arrest were subjected to three different interventional resuscitation: operation with saline treatment (group Con), with epinephrine treatment (group Epi), with combinatory treatment of epinephrine and U50,488H(group EU). Each group eventually had 20 survivors after 2 h recovery. Before cardiac resuscitation, both Con and Epi groups were administrated with 0.2 ml of normal saline and group EU was administrated with 0.2 ml of U50,488H (1 mg/kg) through femoral vein. During cardiac resuscitation, both Epi and EU groups were administrated with epinephrine. Hemodynamic and cardiac function parameters were obtained at 0 min, 10 min, 30 min, 1 h, 2 h after spontaneous circulation recovery. And the success rate of resuscitation among three groups were calculated. Results The survival rate at 30 min and 2 h after cardiac resuscitation did not differ between group Epi and group EU(P>0.05). Compared with group Con, the time of spontaneous circulation recovery (Tcpr) was significantly decreased in both group Epi and group EU (P<0.05). Compared with those in group Epi, there was no difference in all parameters of cardiac function, including HR, MAP, maximal rising rate of blood pressure in the ventricular chamber (dp/dtmax), maximal decline rate of blood pressure in the ventricular chamber(-dp/dtmax) and left ventricular end-diastolic pressure (LVEDP) in group EU at immediately, 10 min, 30 min and 1 h after resuscitation. At 2 h after resuscitation, MAP, dp/dtmax, -dp/dtmax,and LVEDP were significantly different in group EU, compared with those in group Epi(P<0.05). Conclusions These results demonstrate that a combination of epinephrine and κ-opioid agonist U50,488H(1 mg/kg) did not affect the success rate of early resuscitation in rats undergoing cardiac arrest, but improves left ventricular systolic and diastolic functions 2 h after resuscitation, compared with epinephrine treatment alone.

Key words: Cardiac arrest; Ischemia-reperfusion injury; Resuscitation; κ-opioid receptor; Postconditioning