摘要
目的研究心搏骤停大鼠心肺复苏早期应用乌司他丁(Ulinastatin,UTI)对自主循环恢复后2 h 心肌氧自由基、血清CKMB、TNFα及大鼠心肌超微结构的影响。方法利用窒息导致大鼠心脏骤停后心肺复苏的动物模型,将 Wistar 大鼠随机分为3组:对照组、常规复苏组、UTI 治疗组,每组8只。于自主循环恢复2 h 取动脉血,测定血清中 CK-MB、TNFα的含量;取心肌组织,制备心肌匀浆测 NO、MDA 含量及 SOD 的活性。采用透射电镜观察心肌细胞的超微结构。结果常规复苏组与对照组比较,血清TNFα明显升高(P<0.01),血清 CKMB、心肌 MDA,NO 有升高趋势,SOD 活性降低.电镜下对照组心肌细胞超微结构正常,常规复苏组心肌细胞部分线粒体外膜不完整,线粒体嵴模糊不清,有肿胀;乌司他丁组各项指标检测结果较常规复苏组好,电镜下可见细胞线粒体增生,线粒体嵴结构正常。结论心肺复苏大鼠存在心肌损伤,乌司他丁组 CK-MB、TNFα、自由基以及心肌超微结构均较常规复苏组有改善,对复苏后心肌损伤有一定的保护作用。
Objective To observe the effects of ulinastatin （ UTI ） on the concentration of serum CK-MB, TNFtx, myocardial free radicales and cellular ultrastructure in rats after autonomous circulatory resuscitation. Methods Cardiac arrest was induced by asphyxiation, 24 Wistar rats were randomly divided into 3 groups, control group; routine treatment group and UTI treatment group （ n = 8, per group）. 2 hours after spontaneous circulation recovery （ ROSC）, arterial blood was aspirated for determination of serum TNFa and CKMB, and concentration of NO, MDA and activities of SOD in myocardium were measured, Cellular ultrastructure was observed by transmission electron microscope. Results Compared with control group, serum TNF（ P 〈0.01 ） and CK-MB in routine treatment group increased , the quanity of maleic dialdehyde （MDA） and nitric oxide （NO） also increased , meanwhile, enzyme activity of superoxide dismutase （SOD） in the heart decreased. No abnormal alternations in myocardial ultrastructure were observed in control group, In routine treatment group, ultrastructurc injuries suchas incomplete mitochondria membrane, unclear and swelling mitochondrial cfista were observed, Viable apoptotic cell were observed occasionally. Compared with routine treatment group, ulinastatin treatment group showed a reduction of serum CK-MB and TNFa level. The mitochondrial hyperplasia was observed, while mitochondrial crista was normal. Conclusion Autonomous circulatory resuscitation could result in the injury in myocardial cells. Compared with routine treatment group, there were improvements of CK-MB, TNFa and free radical in Ulinastatin group. The ultrastroctural injury of myocardial cell was also alleviated. Ulinastatin can protect the myocardium of rats after resuscitation.
出处
《临床急诊杂志》
CAS
2006年第6期270-274,共5页
Journal of Clinical Emergency
关键词
心肌损伤
自主循环复苏
乌司他丁
Myocardial injury
Autonomous circulatory resuscitation
Ulinastatin
