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目的探讨氨茶碱与肾上腺素在大鼠窒息致心脏停搏模型中对心脏硬度的影响。方法采用呼气末夹闭气管方法建立起大鼠心脏停搏模型。48只大鼠随机分为生理盐水对照组(对照组)、氨茶碱组、肾上腺素组、氨茶碱与肾上腺素合用组(合用组),心肺复苏后1h处死动物尸检观察心脏硬度。结果①氨茶碱组心肌硬度记分(2．92±0．79)和肾上腺组(3．92±1．00)均高于对照组(2．17±0．83,P均＜0．05);②合用组心肌硬度记分(2．50±1．09)低于肾上腺组,差异具统计学意义(P=0．003);③氨茶碱组、肾上腺素组和合用组自主循环恢复动物的心脏硬度记分均值均明显低于未恢复者,且差异均具统计学意义(P均＜0．05);④复苏后1h处死动物心脏硬度记分与复苏过程中最高收缩压、舒张压和平均压之间均存在中度正相关(P均＜0．05)。结论在窒息致心脏停搏大鼠模型中肾上腺素与氨茶碱均可导致心脏硬度的增加,这种心脏过度收缩致舒张障碍,即石头心现象,可能是其复苏失败的原因之一。
Objective To investigate the effect of aminophylline and epinephrine on cardiac stiffness in asphyxial rat cardiac arrest model. Methods End-stage tracheal occlusion was used to establish rat cardiac arrest model. Forty-eight rats were randomly divided into normal saline control group, aminophylline group, epinephrine group, aminophylline and epinephrine combined group (combination group), 1 h after cardiopulmonary resuscitation animals were sacrificed to observe the heart stiffness. Results ① The scores of myocardial stiffness in aminophylline group (2.92 ± 0.79) and adrenal group (3.92 ± 1.00) were significantly higher than those in control group (2.17 ± 0.83, P <0.05 respectively) ); ②Compared with adrenal group, the score of myocardial stiffness in combined group (2.50 ± 1.09) was statistically significant (P = 0.003); ③Aminophylline group, epinephrine group and combined group recovered spontaneously The average score of cardiac stiffness of animals was significantly lower than that of non-recovered ones (all P <0.05); ④At 1 h after resuscitation, the highest score of systolic and diastolic blood pressure There was a moderate positive correlation between mean pressure (P <0.05). Conclusions Both epinephrine and aminophylline can induce the increase of heart stiffness in asphyxial rat model of cardiac arrest. This phenomenon of diastolic dysfunction caused by excessive contraction of the heart may be one of the reasons for failure of recovery.