心肺复苏早期心肌的损伤及参附注射液的保护作用

目的:观察参附注射液对心搏骤停患者在心肺复苏早期的心肌保护作用,并探讨其作用机制。方法:将32例心搏骤停患者随机分成两组,除常规进行体外心肺复苏及给予复苏药物治疗外,治疗组在复苏开始后即应用参附注射液静脉注射,对照组仅给予等量的生理盐水。观察两组患者恢复有效自主心跳时间,并监测复苏后的心率,血压情况。同时检测患者复苏即刻、复苏后1、3、24h心肌肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白I(TnI)、脑利钠肽(BNP)及高敏C反应蛋白(hs-CRP)的水平。结果:①参附注射液治疗组患者恢复有效自主心跳的时间较对照组明显缩短,血压回升更快;②两组患者心脏恢复灌注后CK-MB、TnI及BNP均呈上升趋势,但治疗组的升高幅度显著低于对照组(P<0.05);③参附注射液治疗显著抑制了心肺复苏后的炎症反应,hs-CRP较对照组明显下降。结论:参附注射液增加了心肺复苏的成功率,减轻复苏后的心肌损伤和心功能障碍。

Shenfu injection attenuates the injury and dysfunction of myocardium in the early stage of cardiopulmonary resuscitation

Objective:To explore the effects and mechanism of Shenfu injection on the cardiac arrest patients treated with cardiopulmonary resuscitation(CPR).Method:32 cases of cardiac arrest patients were randomly divided into two groups and both were treated with CPR.17 patients were given Shenfu injection when CRP began,and the others were given 0.9 % sodium chloride only as control.CK-MB,TnI,BNP and hs-CRP in both groups were measured at the beginning of CPR,1 h,3 h and 24 h after reperfusion.Result:There was a rising trend of CK-MB,TnI and BNP after heart reperfusion in both groups,but the rising extent in shenfu injection treated group was obviously lower than that in control group(P<0.05).Meanwhile,Shenfu injection also significantly decreased the elevation of hs-CRP after CPR.Conclusion:Shenfu injection attenuates the injury and dysfunction of myocardium after CPR and increase the successful rate of resuscitation.