目的:研究在心肺复苏中肾上腺素对自主循环恢复(ROSC)前大鼠心肌损伤情况及可能机制。方法:SD雄性大鼠50只,随机分为4组:空白对照组(O)、复苏对照组(C)、大剂量肾上腺素组(H)、标准剂量肾上腺素组(S)。采用大鼠心肺复苏模型,心跳恢复立即取心肌标本,检测各组心肌组织Na+-K+-ATP酶和SOD活力、cAMP和MDA浓度并进行统计分析;电镜观察心肌细胞超微结构变化。结果:S组与H组心肌ATP酶和SOD活力、MDA浓度有差异;心肌cAMP含量S组、H组无统计学差异,并与心肌损伤程度无相关性。结论:在心肺复苏中与标准剂量肾上腺素比较,大剂量肾上腺素在ROSC前已经加重了心肌组织的损伤,但心肌损伤可能与心肌β1-肾上腺素能受体(β1-AR)无关。 Objective: To investigate the myocardial injury induced by epinephrine in cardiopulmonary resuscitation and its possible mechanism before spontaneous circulation recovery (ROSC) in rats. Methods: Fifty SD male rats were randomly divided into 4 groups: control group (O), resuscitation control group (C), high dose epinephrine group (H) and standard dose epinephrine group (S). Cardiopulmonary resuscitation (CPR) model was used in rats. Myocardial samples were taken immediately after heartbeat recovery. The activities of Na + -K + -ATPase and SOD, cAMP and MDA in myocardium were detected and statistically analyzed. The ultrastructural changes of myocardial cells were observed by electron microscope. Results: The activity of ATPase, SOD and the concentration of MDA in S group and H group were different. The content of cAMP in S group and H group had no statistical difference and had no correlation with the degree of myocardial injury. CONCLUSIONS: Compared with the standard dose of epinephrine, cardiopulmonary resuscitation (CPR) has increased cardiac myocyte damage prior to ROSC, but myocardial injury may not be related to β1-adrenergic receptor (β1-AR).