生脉注射液对心肺复苏兔心肌细胞的作用及应用时机的研究

目的:探讨生脉注射液在心肺复苏中对心肌细胞的保护作用及其应用时机。方法:健康清洁级新西兰大白兔30只,随机分为A,B,C,D,E5组。各组分别采用窒息法制成心搏骤停动物模型,进行心肺复苏。A组为常规复苏组;B,C,D和E组分别在常规复苏同时及复苏5min,10min,15min时缓慢静脉注射生脉注射液(SMI)5ml。分别在窒息前、复苏30min和复苏60min抽取静脉血,检测血清丙二醛(MDA)含量和超氧化物歧化酶(SOD)活力的变化,观察各组动物自主循环恢复时间、自主呼吸恢复时间、自主呼吸恢复率、复苏成功率及心肌细胞的病理和超微结构的改变。结果:加用生脉注射液的B,C,D和E组自主循环、呼吸恢复时间明显缩短,与A组比较有非常显著性差异(P<0.01),加用生脉注射液早者自主循环、呼吸恢复时间较加用晚者缩短(P<0.05或P<0.01)。自主呼吸恢复率A组66.67%,B,C和D组均为100%,E组为83.33%。复苏成功率各组均为100%;SOD活力在窒息前各组间无明显差异(P>0.05),复苏过程中SOD活力逐渐下降,复苏60min时,B,C,D和E组SOD活力均高于A组(P<0.01),加用SMI早者高于加用SMI晚者(B组与C组比较P<0.05,B组与D和E组比较P<0.01)。窒息前各组动物血清MDA含量无统计学差异(P>0.05);复苏60min时,加用SMI的B,C,D和E组MDA含量明显低于常规复苏组,与A组比较均有非常显著性差异(P<0.01),加用SMI早者低于加SMI晚者(B组与C组比较P<0.05,B组与D和E组比较P<0.01,C组与E组比较P<0.05)。复苏后各组心肌细胞一般结构及超微结构均存在不同程度的改变,但各组之间病变程度不同,A组病变最严重,B组病变最轻,C组、D组、E组病变依次加重,但都比A组轻。结论:加用生脉注射液辅助心肺复苏可以缩短复苏兔自主循环和自主呼吸恢复时间,提高自主呼吸恢复率,减少血清MDA的产生,提高SOD活力,延缓SOD活力的下降,减轻复苏兔心肌细胞一般及超微结构的改变,对心肌细胞具有保护作用。生脉注射液的上述作用与应用时机有明显的关系,应用越早,其作用越明显。

Research on Protective Effects of ShengMai Injection on Cardio- plumonary Resucitation of Rabbit's Cardiac Muscle Cell and Its Applcation Time

Objective:To explore the Protective effects of ShengMai injection(SMI)on cardio-plumonary resucitation(CPR)of rabbit's cardiac muscle cell and its applcation time.Methods:30healthy rabbits were randomely divided into the A,B,C,D,and E groups,and were induced by asphyxiation to make cardiac arrest models.Then the variety of MDA and SOD in the serum was examined before asphyxiation,on the CPR30min and60min.The observation was made to see the restoration time of spontaneous circulation and breath,the success rae,the changes of pathology and ultra-micro structure in cardiac cell.Results:The difference between the group A and the other four groups was obvious on the restoration time of spontaneous circulation and breath(P<0.01);the success rate of CPR in each group is100%.The activity of serum SOD was almost the same in each group before the cardiac arrest,and dicreased gradually during the reˉsucitation.60min after resucitation,the SOD activity and the content of MDA in the group A were lower than in the other four groups(P<0.01).After rescuitation,the normal and ultra-micro structure of cardiac cell were changed in different degree,and the group A was the most serious,then the group E,D,C,and the group B was the mild.Conclusions:SIM can lower the restoration time of spontaneous circulation and breath,reduce the production of MDA and SOD in the serum of rabbit.moreover,it can ease the damages in both the normal and ultra-micro structure of cardiac cell and has protective effects.The relationship between the effects of SMI and its application time is obvious;earlyier the time is,better the effect is.