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目的 观察纳洛酮 (naloxone ,NLX)对犬心跳骤停复苏后血流动力学和心肌氧自由基及一氧化氮 (NO)的影响。方法 体外电击诱发犬室颤 ,3min后复苏 ,18只犬随机分为 3组 :CPR组、NLX组、正常对照组 ,每组 6只。采用Swan Ganz漂浮导管监测复苏前和复苏后 6h的CO和PAWP。 6h后取心肌组织 ,匀浆检测超氧化物岐化酶 (SOD)、丙二醛 (MDA)和一氧化氮 (NO)。结果 CPR组的平均动脉压在复苏后 4、 6h低于正常对照组 ,而NLX组在复苏后 2、 4、 6h高于CPR组 ,与正常对照组无差异。CO、CI、SV和LVS .WI在心跳骤停前三组间差异无统计学意义 ,复苏成功后 0～ 6hNLX组和CPR组的各指标均低于正常组 ,而NLX组的CO、CI、SV和LVSWI在复苏后 1～ 6h高于CPR组。复苏后 6hCPR组和NLX组心肌组织SOD活性则低于正常对照组 ,而MDA和NO高于正常对照组 ,NLX组心肌组织MDA和NO含量较CPR组降低 ,而SOD活力较CPR组升高。结论 诱发室颤犬复苏成功后存在心功能不全、氧自由基和NO产生增加和内源性抗氧化机制的削弱 ,NLX能予以改善。
Objective To observe the effects of naloxone (NLX) on hemodynamics and myocardial oxygen free radicals and nitric oxide (NO) after cardiac arrest and resuscitation in dogs. Methods In vitro shock induced canine ventricular fibrillation and resuscitation after 3 minutes. 18 dogs were randomly divided into 3 groups: CPR group, NLX group and normal control group, with 6 rats in each group. CO and PAWP were monitored before and 6 h after resuscitation with Swan Ganz floating catheter. Myocardial tissues were harvested 6 h later. Superoxide dismutase (SOD), malondialdehyde (MDA) and nitric oxide (NO) were detected by homogenization. Results The mean arterial pressure of CPR group was lower than that of normal control group at 4 and 6 hours after resuscitation, while that of NLX group was higher than that of CPR group at 2, 4 and 6 hours after resuscitation, which was not different from that of normal control group. CO, CI, SV and LVS. There was no significant difference in WI between the three groups before cardiac arrest. After resuscitation, the indexes in NLX group and CPR group were lower than those in normal group SV and LVSWI were higher than CPR group 1 ~ 6 h after resuscitation. At 6h after resuscitation, the activity of SOD in myocardium of CPR group and NLX group was lower than that of normal control group, while the content of MDA and NO in NLX group was lower than that in CPR group. The activity of SOD in NLX group was higher than that in CPR group. Conclusions After the successful recovery of ventricular fibrillation dogs, heart failure, oxygen free radicals and NO production increase and endogenous antioxidant mechanism weaken, NLX can be improved.