参附注射液对猝死复苏患者心肌保护作用的临床探讨

目的：探讨参附注射液对心脏骤停患者复苏过程中的心肌保护作用及其作用机制。方法：62例患者被随机分为两组．治疗组（参附组）33例，对照组29例。对两组均给予心肺复苏基本生命支持，同时给予复苏常用药物治疗．参附组在复苏即刻给予参附注射液40ml静推，观察两组病例复苏前、复苏即刻、再灌注0．5h、再灌注1h、再灌注6h心肌酶学肌酸激酶（CK）、肌酸激酶-同工酶（CK-MB）、乳酸脱氢酶（LDH）、血清谷草转氨酶（AST）及超氧物歧化酶（SOD）、一氧化氮（NO）、丙二醛（MDA）]的情况，并运用国产床旁心电监护仪动态监测复苏后并发症的发生率。结果：对照组复苏后各时期血清MDA升高，SOD活性下降，与复苏前比较差异均有显著性（P〈0．01）。与对照组比较，参附组复苏后各时期血清MDA水平较低、SOD、NO水平较高（P〈0．05～〈0．01）；两组复苏后其他心肌酶水平均呈上升趋势．但参附组的升高显著低于同期对照组（P％0．05）；两组患者复苏后均有心律失常发生，参附组的发生率低于对照组（P〈0。05）。结论：较之对照组，参附注射液能使血清NO水平升高．SOD活性增加MDA水平降低．并使LDH、CK、CK-MB水平降低，抑制对心肌的损伤，保护缺血再灌注细胞，降低心律失常发生率。

Protective effect of Shenfu injection on myocardium during cardiopulmonary resuscitation

Objective： To explore the protective effect and its mechanism of Shenfu injection on myocardium during cardiopulmonary resuscitation. Methods： A clinical study was performed in 62 patients including 33 patients with Shenfu injection treatment and 29 cases with routine treatment. Blood samples were collected during the different courses of re- suscitation to investigate the level of myocardial enzymes and SOD, NO, MDA at the same time; the incidences of the complication were also monitored. Results： Compared with the routine treatment group, expression of SOD and NO was markedly increased while expression of MDA and myocardial enzymes significantly decreased in the shenfu treat-ment group during the different courses of cardiopulmonary resuscitation （P〈0.05 or P〈0.01） . The incidence of complications in the shenfu treatment group was less than that of routine treatment group （P〈0.05）. Conclusion： Shenfu injection can protect myocardium from the ischemia--reperfusion injury and improve successful rate by raising NO level and SOD activity, decreasing MDA level.