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目的评价大剂量肾上腺素对大鼠心肺复苏后脑氧合功能的影响。方法雄性Wistar大鼠83只,体重200～280 g,随机分为3组:假手术组(C组,n=25)、标准剂量肾上腺素组(S组,n= 31)、高剂量肾上腺素组(H组,n=27)。腹腔注射10％水合氯醛350mg／kg麻醉,气管切开后行机械通气,游离右侧颈内静脉用于采血,游离左侧颈总动脉,持续监测颈动脉血流,双侧股动脉置管,用于监测平均动脉压、采血及给药。机械通气15min时,采用窒息致心跳骤停,心跳骤停10min时,经主动脉注入由窒息前采集的氧合动脉血与肝素、碳酸氢钠0．1 mEg／100 g和2μg／100 g肾上腺素(S组)／或20μg／100 g肾上腺素(H组)的混合液进行复苏。S组不予采血、窒息、复苏。分别于自主循环恢复(复苏)后30、60、120min时采集动、静脉血,进行血气分析,计算颈动-静脉血氧含量差[C(a-jv)O2]、脑氧摄取率(CEO2)。结果与S组比较,H组复苏成功率差异无统计学意义,复苏开始到复苏的时间缩短(P<0．05)。与C组比较,S、H组复苏后5 min时颈动脉血流升高,复苏后15～120 min时颈动脉血流降低(P<0．01),CEO2、C(a-jv)O2复苏后各时点均升高,但H组低于S组(P<0．05)。结论与标准剂量肾上腺素比较,大剂量肾上腺素降低了脑氧摄取。
Objective To evaluate the effects of high-dose epinephrine on cerebral oxygenation after cardiopulmonary resuscitation in rats. Methods Eighty male Wistar rats weighing 200-280 g were randomly divided into three groups: sham operation group (group C, n = 25), standard dose epinephrine group (group S, n = 31), high dose of epinephrine Group (Group H, n = 27). Peritoneal injection of 10% chloral hydrate 350mg / kg anesthesia, mechanical ventilation after tracheotomy, free right internal jugular vein for blood collection, free left common carotid artery, continuous monitoring of carotid blood flow, bilateral femoral artery catheter , For monitoring mean arterial pressure, blood collection and administration. Mechanical ventilation 15min, the use of asphyxia caused by cardiac arrest, cardiac arrest 10min, the aorta by asphyxiation before the collection of oxygenated arterial blood and heparin, sodium bicarbonate 0.1 mEg / 100 g and 2μg / 100g adrenal (S group) / 20 μg / 100 g epinephrine (H group). S group did not take blood, suffocation, recovery. Blood samples were collected at 30, 60 and 120 minutes after spontaneous circulation resuscitation (resuscitation), blood gas analysis was performed, and carotid-venous blood oxygen content difference [C (a-jv) ). Results Compared with group S, there was no significant difference in success rate of recovery between group H and group A (P <0.05). Compared with group C, carotid artery blood flow increased at 5 min after resuscitation in S and H groups, carotid artery blood flow decreased 15-20 min after resuscitation (P <0.01), while CEO2, C (a-jv) O2 After resuscitation, all the time points increased, but H group was lower than S group (P <0.05). Conclusions Compared with standard dose of epinephrine, high dose of epinephrine decreased cerebral oxygen uptake.