兰州大学机构库 >学院待认领
早期集束化治疗对家兔心脏骤停后综合征心脑保护的实验研究
Alternative TitleEffect of Bundle of Care at Early Stage of Post-cardiac Arrest Syndrome in Rabbits, Myocardial and Brain Function
李俊
Thesis Advisor李培杰
2014-05-21
Degree Grantor兰州大学
Place of Conferral兰州
Degree Name硕士
Keyword心脏骤停后综合征 集束化治疗 治疗性低温 二氢辣椒素
Abstract目的 研究采用α-去甲基肾上腺素(α-MNE)、κ-阿片受体激动剂U50488H、瑞芬太尼及治疗性低温的集束化疗法对家兔心脏骤停后综合征早期心、脑功能及血流动力学优化作用,探索二氢辣椒素(DHC)药物诱导治疗性低温可行性及其可能作用机制。 方法 50只健康成年家兔麻醉置管前随机(随机数字法)分为5组(n=10):手术对照组(A组)、肾上腺素(E)组(B组)、α-MNE+U50488H组(C组)、α-MNE +U50488H +治疗性低温+瑞芬太尼组(D组)、α-MNE+U50488H+ DHC +瑞芬太尼组(E组)。体外电击建立家兔心肺复苏模型,于诱发室颤前15min、复苏后30min、60min、120min、240min、360min动态监测血流动力学指标,检测血清肌钙蛋白(cTnI)、神经元特异性烯醇化酶(NSE)浓度变化。统计学处理采用方差分析。 结果 (1)复苏后,除A组外,其余4组家兔MAP、peak±dp/dt均不同程度下降,LVEDP均不同程度升高(P均<0.05);D、E组家兔各时间点参数无明显差异(P均>0.05);D、E组与B组相比,MAP于60min后各时间点差异有统计学意义(P<0.05),peak±dp/dt、 LVEDP在复苏成功后30min后各时间点差异有统计学意义(P<0.05);D、E组与C组相比,MAP、peak±dp/dt及LVEDP于60min后各时间点差异有统计学意义(P<0.05)。(2)复苏后,除A组外,其余4组家兔cTnI、NSF浓度均不同程度升高(P均<0.05);D、E组家兔各时间点各指标浓度仍无明显差异(P均>0.05);D、E组与B组相比,cTnI、 NSF浓度在复苏后各时间点差异均有统计学意义(P<0.05);D、E组与C组相比,cTnI、NSF质量浓度于60min后各时间点值差异有意义(P<0.05)。(3)D组家兔体表降温至复苏后60min肛温平均降低5.9℃,E组家兔DHC(1.0 mg·kg-1·h-1)药物诱导至复苏后60min肛温平均降低6.0℃,均达到治疗性低温降温目标,无统计学差异(P>0.05)。 结论 DHC静脉滴注可快速、有效诱导治疗性低温,α-MNE、U50488H、瑞芬太尼及治疗性低温的集束化疗法可有效改善心脏骤停后综合征。
Other AbstractObjective: To investigate the myocardial and brain function protection and hemodynamic stability effects of the bundle of care which formed by selective α2-adrenergic receptor agonist alpha-Methylnorepinephrine (α-MNE), κ-opioid receptor agonist U50488H ,remifentani,and Transient receptor potential vanilloid type 1(TRPV1) agonist Dihydrocapsaicin(DHC) drug-induced mild hypothermia at early stage of Post-cardiac arrest syndrome(PCAS) in rabbits. Methods: 50 rabbits were randomly divided into 5 groups; A group: operation control group, only anesthesia and tubes inserted without performing ventricular fibrillation(VF); B group, epinephrine group, injecting epinephrine(30ug/kg) during CPR; C group, injecting α-MNE(100ug/kg) and U50488H(1.5mg/kg) during CPR; D group, the similar to C group during CPR,but when achieved return of spontaneous circulation(ROSC), surface cooling(ice, 100g/100mg) was given to quickly cool rabbit to 32℃-34℃(anal temperature) lasting to the end. Meanwhile, large dose of remifentani (6.0 ug·kg-1·min-1) was continuously pumped intravenously; E group, the similar to C group during CPR too, but after ROSC, DHC (1.0 mg·kg-1·h-1) and remifentani (6.0 ug·kg-1·min-1) were continuously intravenous pumped in order to obtain drug-induced mild hypothermia. Blood samples were collected at before VF, 30min, 60min, 120min, 240min, 360min, and the levers of troponin I(cTnI) and neuron-specific enolase(NSE) were measured, in addition, hemodynamic parameters were also recorded at above time points. Statistical analysis was performed using SPSS software. Results: (1) After CPR, compared with group A, MAP and peak±dp/dt at the time points were significantly lower(P<0.05), and LVEDP were significantly increased(P<0.05)in other four groups, but there were no differences between D and E groups(P>0.05). MAP in D and E groups were significantly higher than that in B group(P<0.05) after the 60 minute point, peak±dp/dt and LVEDP had significant difference (P<0.05) after the 30 minute point too. MAP, peak±dp/dt and LVEDP in D and E groups also had significant difference with C group(P<0.05) after the 60 minute point. (2) cTnI and NSE in A group were significantly lower than that in the other groups(P<0.05). Moreover, there were no statistical differences in D and E groups(P>0.05), but they were higher than B group(after CPR) and C(after the 60 minute point) group(P<0.05). (3) Rabbit treated with surface cooling and DHC decreased f...
URL查看原文
Language中文
Document Type学位论文
Identifierhttps://ir.lzu.edu.cn/handle/262010/222261
Collection学院待认领
Affiliation临床医学院
Recommended Citation
GB/T 7714
李俊. 早期集束化治疗对家兔心脏骤停后综合征心脑保护的实验研究[D]. 兰州. 兰州大学,2014.
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