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目的:探讨在心肺复苏中肾上腺素对自主循环恢复前大鼠心肌损伤与心肌细胞膜β1-肾上腺素能受体的关系。方法:健康雄性(SD)大鼠50只随机分为4组:空白对照组10只(O组)、复苏对照组10只(C组)、大剂量肾上腺素组15只(H组)、标准剂量肾上腺素组15只(S组)。制备大鼠心肺复苏模型,窒息致心跳停止,再进行心肺复苏,心跳恢复立即取心肌标本,检测各组心肌组织Na+-K+-ATP酶和超氧化物歧化酶活力、环磷腺苷和丙二醛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酶和超氧化物歧化酶活力、丙二醛浓度比较差异有统计学意义(P<0.05或P<0.01);心肌环磷腺苷含量S组、H组比较差异无统计学意义(P>0.05),且与心肌损伤程度无相关性;电镜观察各组心肌细胞超微结构变化差异均有统计学意义(P<0.05)。结论:心肺复苏中肾上腺素在自主循环恢复前已加重了心肌组织的损伤,而心肌细胞膜β1-肾上腺素能受体兴奋性增高可能不是主要的原因。
OBJECTIVE: To investigate the relationship between epinephrine and cardiomyocyte membrane β1-adrenergic receptor in cardiopulmonary resuscitation rats before cardiopulmonary resuscitation. Methods: Fifty healthy male SD rats were randomly divided into 4 groups: 10 in the blank control group (group C), 10 in the control group (group C) and 15 in the high-dose epinephrine group (group H) The dose of epinephrine group 15 (S group). Cardiopulmonary resuscitation rat model was prepared, asphyxia caused cardiac arrest, and then cardiopulmonary resuscitation, heart rate recovery immediately take myocardial samples to detect myocardial tissue Na + -K + -ATPase and superoxide dismutase activity, cyclic adenosine monophosphate and propylene two Aldehyde concentration and statistical analysis; electron microscopy myocardial cell ultrastructure changes. Results: There were significant differences in myocardial ATPase activity, SOD activity and malondialdehyde concentration between S and H groups (P <0.05 or P <0.01) There was no significant difference between the two groups (P> 0.05), but not with the degree of myocardial injury. The ultrastructural changes of myocardial cells were observed by electron microscope (P <0.05). CONCLUSIONS: Adrenaline during cardiopulmonary resuscitation has increased myocardial damage prior to spontaneous circulation recovery, whereas increased excitability of the β1-adrenergic receptor in myocardial cell membranes may not be the primary cause.