甲泼尼龙琥珀酸钠对窒息型大鼠复苏后早期的心功能影响

目的:探讨甲泼尼龙琥珀酸钠(甲强龙)对窒息大鼠模型心肺复苏后早期心功能的影响及机制。方法:45只SD大鼠,雌雄不拘,分为对照组、常规复苏组(常规复苏+肾上腺素10μg/kg)和甲强龙组(常规复苏+肾上腺素10μg/kg+甲强龙1.8 mg/kg)。对窒息大鼠模型进行心肺复苏,记录平均动脉压(MAP)、左心室收缩压(LVSP)和左心室舒张末压(LVEDP)的变化,ELISA法检测大鼠心脏组织中肾上腺素能α1受体和β1受体水平。结果:在心肺复苏自主循环恢复(ROSC)30 min后,与对照组比较,常规复苏组及甲强龙组大鼠的MAP和LVSP均有明显下降(P均0.05);在ROSE后0、15 min时,常规复苏组及甲强龙组LVEDP与对照组相比有显著性差异(P均0.05)。甲强龙组MAP在ROSC后60、120 min时,LVSP在ROSC后30、60、120 min时均显著高于常规复苏组(P均0.05)。心肺复苏后,甲强龙组与对照组、常规复苏组比较,心脏组织中肾上腺素能α1受体和β1受体水平均明显升高(P均0.05)。结论:甲强龙可提高心肺复苏后心脏组织内肾上腺素能α1受体和β1受体含量,有利于心肺复苏后MAP和LVSP的稳定。

Effects of methylprednisolone on myocardial function at early stage of resuscitation in the rats model of asphyxia

Objective:To investigate the effects and mechanism of methylprednisolone on myocardial function at early stage of resuscitation in the rats model of asphyxia. Methods:A total of 45 health SD rats were randomly divided into the control group,conventional resuscitation group (routine resuscitation + epinephrine 10 μg/kg ) and methylprednisolone group (routine resuscitation +epinephrine 10 μg/kg + methylprednisolone 1.8 mg/kg).Hemodynamic indexes of mean arterial pressure (MAP),left ventricular systolic pressure (LVSP)and left ventricular end-diastolic pressure (LVEDP)were collected to estimate myocardial function.The levels ofα1 andβ1 adrenoreceptors in the cardiac tissue were detected by ELISA. Results:At 30min,60 min and 120 min after recovery of spontaneous circulation (ROSC ), the MAP and LVSP of conventional resuscitation group and methylprednisolone group were significantly decreased compared with the control group (all P<0.05). The LVDEP of conventional resuscitation group and methylprednisolone group were significantly higher than that of the control group at 0 min and 15 min after ROSC (all P<0.05).However,the MAP of methylprednisolone group was significantly higher than that of conventional resuscitation group at 60 min and 120 min after ROSC (both P<0.05 ).The LVSP of methylprednisolone group was significantly higher than that of conventional resuscitation group at 30min,60min and 120min after ROSC (all P<0.05).The levels ofα1 andβ1 adrenoreceptors in the cardiac tissue of methylprednisolone group were significantly increased compared with the control group and conventional resuscitation group after cardiopulmonary resuscitation (all P<0.05 ). Conclusion:The methylprednisolone can increase the levels of theα1 andβ1 adrenoreceptors in the cardiac tissue,which is beneficial to the stabilization of MAP and LVSP after cardiopulmonary resuscitation.