论文部分内容阅读
目的研究心搏骤停大鼠心肺复苏早期应用氨茶碱对复苏成功率、血液流变学、心功能及大鼠心肌超微结构的影响。方法选60只SD大鼠,随机分为3组:手术对照组(A组),肾上腺素治疗组(B组)和肾上腺素+氨茶碱治疗组(C组),各20只。分别于窒息前、自主循环恢复时及自主循环恢复30min后进行血流动力学及心功能测定,电镜观察心肌超微结构的变化。结果比较自主循环恢复时间,C组明显少于B组(P<0.05)。C组中有75%自主循环恢复,30min存活率为70%,B组分别为60%(P>0.05)和55%(P>0.05)。C组自主循环恢复时及自主循环恢复30min后的LVSP、dp/dtmax、经LVSP校正后的dp/dt和-dp/dt均明显高于B组(P<0.05)。A组心肌细胞超微结构正常,C组复苏后心肌超微结构略有部分改变,线粒体轻度肿胀及少量空泡形成。B组复苏后心肌细胞部分损害,心肌细胞肌丝排列不整齐,线粒体明显肿胀及空泡化,损害程度比C组严重。结论在复苏早期应用腺苷受体拮抗剂氨茶碱提高了复苏成功率,并且改善了心脏功能,减少了对心肌细胞超微结构的破坏,因此,氨茶碱可作为肾上腺素的增补剂。
Objective To study the effect of aminophylline on the success rate of resuscitation, hemorheology, cardiac function and myocardium ultrastructure in cardiopulmonary resuscitation rats after cardiac arrest. Methods Sixty SD rats were randomly divided into three groups: operation control group (A group), adrenaline treatment group (B group) and epinephrine + aminophylline treatment group (C group). The hemodynamics and cardiac function were measured before resuscitation, at the time of spontaneous circulation recovery and after spontaneous circulation recovery for 30 minutes respectively. The changes of myocardial ultrastructure were observed by electron microscope. Results Compared with spontaneous circulation recovery time, group C was significantly less than group B (P <0.05). 75% of the patients in group C recovered spontaneously, the survival rate was 30% at 30 minutes, and 60% (P> 0.05) and 55% (P> 0.05) in group B respectively. The LVSP, dp / dtmax and the dp / dt and -dp / dt after LVSP were significantly higher in group C than those in group B (P <0.05) at and after spontaneous circulation recovery. The ultrastructure of myocardium in group A was normal, the ultrastructure of myocardium in group C was slightly changed, the mitochondria were slightly swollen and the number of vacuoles was formed. In group B, myocardial cells were partially damaged after injury, myocardial cells were irregularly arranged, mitochondria were obviously swollen and vacuolated, and the degree of damage was more serious than that in group C. Conclusion In the early recovery of the application of adenosine adenosine receptor antagonist increased the success rate of recovery, and improve cardiac function and reduce the destruction of myocardial ultrastructure, therefore, aminophylline can be used as a supplement of epinephrine.