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目的评价血管加压素对大鼠心肺复苏(CPR)后早期心脏舒张功能的影响。方法取12周龄SD大鼠36只,体量(300±20)g,随机分为3组,每组12只。A组(假手术组):仅气管切开插管和右颈总动脉置管;E组(肾上腺素组):窒息致心脏骤停(CA)后用肾上腺素0.02 mg/(kg.次)进行CPR;V组(血管加压素组):用血管加压素0.8 U/(kg.次)进行CPR。记录每只大鼠窒息前(T0)、自主循环恢复(ROSC)后即刻(T1)、2 h(T2)、4 h(T3)HR、SBP、DBP、LVEDP、-LVdp/dt、动脉血气、CA时间、ROSC时间、ROSC率;检测T3时血清心肌肌钙蛋白(CTnT)及脑钠素(BNP)水平。结果①与V组相比,E组ROSC时间长而ROSC率低(P<0.05)。②E、V组ROSC后各时刻HR、SBP、-LVdp/dt及E组DBP较T0均降低(P<0.05);与V组相比,E组T3时HR,T2、T3时SBP,T1、T2、T3时DBP、-LVdp/dt均降低,而T1、T2、T3时LVDEP升高(P<0.05)。③E组ROSC后各时刻pH、PO2、PCO2、较T0差异有统计学意义(P<0.05);V组ROSC后各时刻PO2、PCO2较T0差异有统计学意义(P<0.05);与V组比较,E组T1时PCO2高,T2、T3时PO2低,T1、T2、T3时pH低(P<0.05)。④3组间CTnT差异以及A组与E、V组间BNP差异均有统计学意义(P<0.05)。结论血管加压素可以减轻大鼠CPR后早期心脏舒张功能不全。
Objective To evaluate the effect of vasopressin on early cardiac diastolic function after cardiopulmonary resuscitation (CPR) in rats. Methods Thirty - six SD rats aged 12 weeks were randomly divided into three groups (n = 12). Group A (sham operation group): only tracheotomy cannula and right common carotid artery cannulation; Group E (epinephrine group): epinephrine 0.02 mg / (kg) after asphyxial cardiac arrest (CA) CPR group V (vasopressin group): CPR was performed with vasopressin 0.8 U / (kg. Times). The changes of HR, SBP, DBP, LVEDP, -LVdp / dt, arterial blood gas, arterial blood gas and blood pressure before and after spontaneous circulation recovery (ROSC) CA time, ROSC time and ROSC rate. Serum cardiac troponin (CTnT) and brain natriuretic peptide (BNP) levels were detected at T3. Results ① Compared with V group, ROSC in E group was longer and ROSC rate was lower (P <0.05). Compared with V group, the DBP of HR, SBP, -LVdp / dt and E group were lower than that of T0 in E, V group at each time point after ROSC (P <0.05) DBP and -LVdp / dt decreased at T2 and T3, but increased at T1, T2 and T3 (P <0.05). (3) There were significant differences in pH, PO2 and PCO2 between the two groups at each time point after ROSC (P <0.05), PO2 and PCO2 at each time point after ROSC in V group were significantly different from T0 (P <0.05) In group E, PCO2 was higher at T1, lower at T2 and T3, and lower at T1, T2 and T3 (P <0.05). ④ The difference of CTnT in 3 groups and the difference of BNP in group A and E, V were statistically significant (P <0.05). Conclusion Vasopressin can reduce early cardiac diastolic dysfunction after CPR in rats.