摘要
目的探讨心肌内质网Ca^2＋调控蛋白表达与心肺复苏（CPR）后心功能障碍的关系。方法38只SPF级雄性SD大鼠按随机数字表法分为对照组（12只）和心搏骤停组（26只）。静脉弹丸式注射氯化钾40μg/g诱导心搏骤停，8 min后进行CPR；对照组大鼠仅麻醉后置管并监测指标，不诱导心搏骤停。在复苏后进行有创血流动力学监测1 h，采用超声心动图测定心功能。分别于自主循环恢复（ROSC）后5 min和60 min时采集心肌标本，采用蛋白质免疫印迹试验（Western Blot）检测内质网Ca^2＋ATP酶（SERCA2a）、磷酸化受磷蛋白（p-PLB）和兰尼定受体（RyR）水平。结果心搏骤停组ROSC率为92.3%（24/26），平均复苏时间为（68±39）s。心搏骤停组复苏后1 h心功能明显下降，与对照组相比，射血分数、短轴缩短率（FS）、左室内压上升或下降最大速率（±dp/dt max）明显降低〔射血分数：0.548±0.060比0.809±0.043，F＝71.692，P＝0.000；FS：（34.4±4.4）%比（46.0±3.5）%，F＝55.443，P＝0.000；＋dp/dt max （mmHg/s）：4718±743比7098±394，P＜0.01；-dp/dt max （mmHg/s）：-3824±612比-6187±473，P＜0.01〕。与对照组相比，心搏骤停组ROSC后5 min及60 min PLB磷酸化水平（灰度值）均显著降低（5 min：0.64±0.15比1.29±0.13，P＜0.01；60 min：0.95±0.08比1.30±0.09，P＜0.05），而内质网SERCA2a活性（灰度值）和RyR水平（灰度值）差异均无统计学意义（SERCA2a 5 min：1.01±0.18比1.24±0.07，60 min：1.03±0.14比1.25±0.06；RyR 5 min：0.96±0.13比0.97±0.13，60 min：0.88±0.14比0.99±0.11，均P＞0.05）。结论内质网PLB磷酸化水平异常与CPR后心功能障碍密切相关。
Objective To investigate the relationship between sarcoplasmic reticulum Ca^2＋modulation proteins and postresuscitation myocardial dysfunction. Methods Thirty-eight SPF male Sprague-Dawley （SD） rats were randomly divided into control group（n=12）and cardiac arrest（CA）group（n=26）. CA was induced by intravenous bolus of potassium chloride（40μg/g）,and cardiopulmonary resuscitation（CPR）was conducted 8 minutes later. No CA was induced in control group except catheter placement for monitoring cardiopulmonary parameters after anesthesia. Invasive hemodynamic parameters were monitored for 1 hour after CPR. Echocardiogram was performed to evaluate cardiac function. Myocardial samples were harvested 5 minutes and 1 hour after restoration of spontaneous circulation （ROSC）,and sarcoplasmic reticulum Ca^2＋ ATPase （SERCA2a）,phosphorylated phospholamban （p-PLB） and rynodine receptor（RyR）were determined by Western Blot. Results ROSC rate of CA group was 92.3%（24/26）,and mean recovery time was （68 ±39）seconds. Cardiac function was significantly impaired in CA group at 1 hour after resuscitation, and ejection fraction, fraction shortening （FS）, the maximal rate of left ventricular pressure increase/decline （±dp/dt max）were significantly decreased compared with those in control group 〔ejection fraction：0.548±0.060 vs. 0.809±0.043,F=71.692,P=0.000;FS：（34.4±4.4）%vs. （46.0±3.5）%,F=55.443,P=0.000;＋dp/dt max（mmHg/s）：4 718±743 vs. 7 098±394,P〈0.01;-dp/dt max（mmHg/s）：-3 824±612 vs.-6 187±473,P〈0.01〕. Compared with control group,the expression levels of p-PLB （gray value）was significantly decreased at 5 minutes and 60 minutes（5 minutes：0.64±0.15 vs. 1.29±0.13,P〈0.01;60 minutes：0.95±0.08 vs. 1.30±0.09,P〈0.05）after resuscitation in CA group,while the level of sarcoplasmic SERCA2a（gray value）and RyR （gray value）showed no significant differences（SERCA2a 5 minutes：1.01±0.18 vs. 1.24±0.07,60 minutes：1.03± 0
出处
《中华危重病急救医学》
CAS
CSCD
北大核心
2014年第10期697-700,共4页
Chinese Critical Care Medicine
基金
国家自然科学基金资助项目（81071539）
四川省中医药局科研项目（0080329）
关键词
心肺复苏
内质网Ca^2+调控蛋白
受磷蛋白
心肌顿抑
Cardiopulmonary resuscitation
Sarcoplasmic reticulum Ca2＋ATPase
Phospholamban
Myocardial stunning
