乌司他丁对大鼠心肺复苏后心肌损伤的保护作用

目的 探讨大鼠心肺复苏(CPR)后血清心肌酶的变化、心肌超微结构改变.以及乌司他丁的干预作用.方法 将120只SD大鼠随机分为假手术组、复苏组、药物组,再按气管切开后或自主循环恢复(ROSC)后0.5、3、6、12、24 h分为5个亚组,每个亚组8只.采用窒息法建立大鼠心脏停搏(CA)和CPR模型.药物组于ROSC后2 min内经颈动脉推注乌司他丁100 kU/kg;复苏组给予等量生理盐水.测定各组大鼠血清肌酸激酶同工酶(CK-MB)、肌钙蛋白I(cTnI)含量;电镜下观察心肌超微结构改变.结果 复苏组、药物组血清CK-MB含量从ROSC后0.5 h起均明显增高,于12 h达峰值.之后均有所下降;cTnI含量于ROSC后0.5 h起均逐渐增高;两者各时间点均较假手术组明显升高,差异均有统计学意义(P均<0.01).与复苏组比较,药物组ROSC后3 h起血清CK-MB含量均明显降低,cTnI含量于ROSC后0.5 h起均明显降低(P<0.05或P<0.01).药物组心肌超微结构病理损害明显轻于复苏组.结论 乌司他丁能降低大鼠CPR后血清CK-MB和cTnI含量,减轻大鼠心肌损伤,对心肌具有一定的保护作用.

Protective effect of ulinastatin on myocardium after cardiopulmonary resuscitation in rats

Objective To investigate the changes in serum creatine kinase isoenzyme (CK-MB) and cardiac troponin I (cTnI) levels and the uhrastructure of myocardium, and the effect of ulinastatin after cardiopulmonary resuscitation (CPR) in rats. Methods One hundred and twenty Sprague-Dawley (SD) rats were randomly divided into sham operation group, CPR group and ulinastatin group. And each group was divided into five subgroups (n=8) according to time points of 0. 5, 3, 6, 12, 24 hours after tracheostomy in sham operation group or after restoration of spontaneous circulation (ROSC) in CPR group and ulinastatin group. Cardiac arrest (CA) and CPR models were reproduced by asphyxia in CPR group and ulinastatin group, with injection of ulinastatin 100 kU/kg via carotid 2 minutes after ROSC in ulinastatin group. Normal saline was given in the same dosage as ulinastatin in CPR group. Serum samples was taken at each time point of subgroups for measuring serum levels of CK-MB and cTnI. The uhrastructure changes in myocardium were observed under the electron microscope. Results The serum levels of CK-MB and cTnI were increased from 0. 5 hours after ROSC in CPR group and ulinastatin group compared with sham operation group (all P<0. 01), and CK-MB peaked at 12 hours, then decreased. The serum CK-MB or cTnl levels started to decreased from 3 hours or 0. 5 hours after ROSC in ulinastatin group compared with CPR group (P<0.05 or P<0. 01). There were milder pathological changes of uhrastructure of myocardium in ulinastatin group than in CPR group. Conclusion Ulinastatin could decrease serum levels of CK-MB and cTnI, and alleviate myocardial injury after CPR in rats.