|Alternative Title||Effect of Bundle of Care at Early Stage of Post-cardiac Arrest Syndrome in Rabbits， Myocardial and Brain Function
|Place of Conferral||兰州
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）。
|Other Abstract||Objective: 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...|
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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