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目的:比较血管加压素与肾上腺素对心肺复苏大鼠心肌损伤的程度。方法:60只雄性SD大鼠随机分为模型组、阴性对照组、血管加压素组及肾上腺素组,每组15只。模型组仅行窒息前准备,不实施窒息处理,其他3组成功建立心搏骤停模型后分别经尾静脉注射生理盐水、血管加压素0.4 u/kg和肾上腺素0.04 mg/kg。记录大鼠自主循环恢复后30 min内血压、心率及存活时间;采用免疫组织化学方法检测白细胞介素-6与肿瘤坏死因子-α水平,分光光度计检测丙二醛、超氧化物歧化酶水平。结果:血管加压素组复苏成功率与肾上腺素组比较差异无统计学意义(P>0.05);在自主循环恢复的30 min内血管加压素组平均动脉压高于肾上腺素组(P<0.05)。自主循环恢复30 min时,模型组丙二醛、超氧化物歧化酶、白细胞介素-6、肿瘤坏死因子-α水平与血管加压素组、肾上腺素组比较差异有统计学意义(P<0.05),血管加压素组丙二醛、超氧化物歧化酶水平与肾上腺素组比较差异无统计学意义(P>0.05);血管加压素组白细胞介素-6和肿瘤坏死因子-α水平低于肾上腺素组(P<0.05)。结论:血管加压素与肾上腺素在大鼠心肺复苏过程中复苏成功率相近,但血管加压素能维持复苏后平均动脉压在较高水平,对心肌细胞的损伤相对较轻。
Objective: To compare the degree of myocardial injury induced by cardiopulmonary resuscitation with vasopressin and epinephrine in rats. Methods: Sixty male SD rats were randomly divided into model group, negative control group, vasopressin group and epinephrine group, with 15 rats in each group. The rats in the model group were only prepared for asphyxiation, without asphyxia treatment. The other three groups were successfully established cardiac arrest model by injection of normal saline, vasopressin 0.4 u / kg and epinephrine 0.04 mg / kg via caudal vein respectively. The blood pressure, heart rate and survival time were recorded within 30 min after spontaneous circulation recovery. The levels of interleukin-6 and tumor necrosis factor-α were detected by immunohistochemical method. The levels of malondialdehyde and superoxide dismutase were measured by spectrophotometer . Results: The success rate of vasopressin resuscitation was not significantly different from that of adrenaline group (P> 0.05). The mean arterial pressure of vasopressin group was higher than that of adrenaline group within 30 min of recovery (P < 0.05). The levels of malondialdehyde, superoxide dismutase, interleukin-6 and tumor necrosis factor-α in model group were significantly different from those in vasopressin and epinephrine groups (P < 0.05). The levels of malondialdehyde and superoxide dismutase in vasopressin group were not significantly different from those in epinephrine group (P> 0.05). The levels of interleukin-6 and tumor necrosis factor-α The level was lower than the adrenaline group (P <0.05). Conclusion: The success rate of vasopressin and epinephrine resuscitation in rats during cardiopulmonary resuscitation is similar, but the vasopressin can maintain the higher average arterial pressure after resuscitation, and the damage to cardiomyocytes is relatively lighter.