摘要
目的观察腺苷在窒息大鼠心肺复苏中对微循环的影响。方法22只成年Wistar大鼠,采用窒息法制作大鼠窒息模型。随机分为对照组(A组,n=10)、肾上腺素组(B组,n=6)和肾上腺素-腺苷组(C组,n=6)。大鼠持续窒息3min后,电动心肺复苏机行胸外心脏按压(200次/min),小型动物呼吸机辅助呼吸(潮气量4ml,呼吸频率50次/min,吸氧浓度100%),4min后静脉给药。A组不用复苏药物;B组静脉注射肾上腺素90μg/kg;C组静脉注射肾上腺素90μg/kg并持续静脉滴注腺苷70μg/kg至复苏结束。有室颤者可予电除颤。观察肠系膜微动脉和微静脉血管再通率,血管管径和血流相对速度变化。结果C组微动脉和微静脉再通率明显高于B组(P<0.05);微动脉和微静脉血管管径复苏后30min,C组均明显好于B组(P<0.05);微动脉再灌注后血流相对速度差异不大,微静脉复苏后30min和60min血流相对速度C组大于B组(P<0.05)。结论心肺复苏时联合应用肾上腺素和腺苷可能会减轻肾上腺素的部分负面作用,改善窒息心肺复苏大鼠肠系膜微循环。
Objective To evaluate the effect of continuous adenosine infusion on mesentery microcirculation during cardiopulmonary resuscitation in rats with asphyxia. Methods Rat model of asphyxia was established in 22 healthy Wistar rats. The animals were then randomly divided into normal saline group （group A, n=10）, epinephrine group （group B, n=6） and epinephrine plus adenosine group （group C, n=6）. After a 3-min asphyxia without intervention, cardiopulmonary resuscitation （CPR） was started. The cardiac compression was carried out with an electric cardio-pulmonary resuscitation machine （200 times/min）. Respiration was restored and maintained with a ventilator with tidal volume of 4ml, breathing rate 50times/min and FiO2 100%. After a 4-min CPR, rats in group A and group B were given normal saline and epinephrine （bolus of 90μg/kg） respectively, and in group C epinephrine （bolus of 90μg/kg） plus 70μg/kg adenosine were given. Electric defibrillation would be initiated if there was ventricular fibrillation. The reperfusion rate of mesentery arterioles and venules, diameter of blood vessels and relative blood velocity were observed. Results The reperfusion rate of mesentery arterioles and venules was significantly higher in group C than in group B （P0.05）. The diameter of arterioles and venules was larger in group C than in group B 30min after resuscitation （P0.05）. No significant difference existed in the arteriole relative blood velocity among the 3 groups after reperfusion, while the relative blood velocity of venule was faster in group C than in group B at 30min and 60min after reperfusion. Conclusions Adenosine could abate the adverse effects of epinephrine in CPR, and improve mesentery microcirculation of asphyxia rats during cardiopulmonary resuscitation.
出处
《解放军医学杂志》
CAS
CSCD
北大核心
2010年第3期301-303,共3页
Medical Journal of Chinese People's Liberation Army
基金
解放军总医院苗圃基金项目(07MP74)
关键词
心肺复苏术
肾上腺素
腺苷
微循环
Cardiopulmonary resuscitation
epinephrine
adenosine
microcirculation
