新型腹腔降温法对心肺复苏后兔炎症反应的影响

目的:观察心肺复苏(CPR)后不同降温方法对自主循环恢复(ROSC)后兔炎症反应的影响。方法:48只新西兰成年大白兔,采用交流电致颤的方式建立CPR模型, 依据降温方式的不同,随机分为常温组(NT)、腹腔内降温组(PC)、体表降温组(SC)和头部局部降温组(LC)。观察不同降温方法对ROSC后血浆TNF-α和IL-6浓度的影响,ROSC后12 h取肝脏组织,Western blotting检测NF-κB p65和NF-κB p50蛋白表达。记录每组动物的存活时间并进行比较。结果:ROSC后4 h、8 h和12 h,PC组血浆TNF-α水平显著低于NT组;至12 h时PC组也显著低于SC组和LC组(P<0.05);ROSC后2 h、4 h、8 h和12 h,PC组血浆IL-6水平明显低于NT组(P<0.05),而与SC、LC组间无显著差异。ROSC后12 h,PC组肝核蛋白内NF-κB p65和p50蛋白表达水平显著低于其它各组(P<0.05),而其它3组之间差异无统计学意义。ROSC后PC组动物的存活率显著高于NT、SC和LC组(P<0.05或P<0.01)。结论:CPR后腹腔降温法可快速诱导亚低温和降低腹腔内温度,抑制肝脏内NF-κB的激活,降低血浆TNF-α和IL-6水平,减轻ROSC后全身炎症反应,延长动物存活时间。

Effects of peritoneal cooling on inflammation after cardiopulmonary resuscitation in rabbits

AIM:To explore the effects of different cooling methods on systemic inflammation after cardiopulmonary resuscitation(CPR) in New Zealand rabbits. METHODS:Ventricular fibrillation in 48 adult New Zealand rabbits was induced by alternating current and was resuscitated after cardiac arrest for 5 min. The rabbits were randomly divided into 4 groups according to the way of cooling methods:normothermia group(NT), peritoneal cooling group(PC), surface cooling group(SC) and local cooling group(LC). The plasma concentrations of tumor necrosis factor α(TNF-α) and interleukin-6(IL-6) were measured in each group at different time points after return of spontaneous circulation(ROSC). The liver tissues were removed 12 h after ROSC, and the levels of NF-κB p65 and NF-κB p50 were tested by Western blotting. The survival time was recorded and compared 96 h after ROSC. RESULTS:The plasma concentration of TNF-α in PC group was lower than that in NT group 4 h, 8 h and 12 h after ROSC, and was also lower than that in SC group and LC group 12 h after ROSC. The level of IL-6 in PC group was lower than that in NT group 2 h, 4 h, 8 h and 12 h after ROSC, while there was no difference between the other 2 groups. The levels of p65 and p50 in PC group were lower than those in other groups(P<0.05), while there was no difference between the other 3 groups. The cumulative survival rate after ROSC in PC group was higher than that in NT group, SC group and LC group. CONCLUSION:The novel peritoneal cooling rapidly induces and maintains mild hypothermia, and decreases the peritoneal temperature quickly, thus inhibiting liver NF-κB activation, reducing the releases of TNF-α and IL-6, subsequently relieving systemic inflammation after ROSC and prolonging rabbit survival.