不同复苏措施对猪心肺复苏后心肌凋亡影响.docVIP

不同复苏措施对猪心肺复苏后心肌凋亡影响 　　【摘要】目的 本研究探讨猪心肺复苏后的心肌功能障碍是否有凋亡机制的参与以及心肺复苏的策略选择对于凋亡是否有影响。方法 22头五指山小型猪被随机（随机数字法）分为假手术组（SHAM）（6只）、先除颤组（DF）和先按压组（CF）（各8只）。建立室颤8 min小型猪模型，监测各组的血流动力学指标，用Western blot法检测心肌组织Bcl-2、Bax和caspase-3的蛋白表达，用实时荧光PCR法定量caspase-3的mRNA水平，TUNEL法检测心肌组织凋亡。应用SPSS 17.0统计软件进行数据处理， 组间比较采用成组t检验，多组均数比较用方差分析。以P0.05）。结论 凋亡机制可能参与了心肺复苏后猪心肌功能障碍，但心肺复苏的策略选择对于凋亡的影响并不大。 　　【关键词】凋亡；心肺复苏；复苏后心肌功能障碍；Caspase-3；Bcl-2/Bax 　　Effects of different resuscitation modalities on post-resuscitation myocardial apoptosis in porcine models of cardiac arrest GU Wei， LI Chun-sheng， YIN Wen-peng， HOU Xiao-min， GUO Zhi-jun， ZHANG Da， WU Cai-jun. Emergency Department， Beijing Chaoyang Hospital， Capital Medical University， Beijing 100020， China 　　Corresponding author：LI Chun-sheng， Email： lcscyyy@163.com 　　【Abstract】Objective To confirm whether in post-resuscitation myocardial dysfunction involved in myocyte apoptosis mechanism in porcine model of cardiac arrest and apoptosis index varied from different modalities of cardiopulmonary resuscitation or not.Methods A total of 22 WZSP inbred small swine were randomly （random number） divided into sham operation group （SHAM） （n=6）， defibrillation first group （DF，n=8） and chest compression first group（CF，n=8）. Eight minutes after ventricular fibrillation was set up， standard CPR was carried out subsequently after defibrillation in porcine models of cardiac arrest in DF group and defibrillation after standard CPR in CF group， and hemodynamics were monitored. Twenty-four hours after restoration of spontaneous circulation （ROSC）， animals were sacrificed， and myocardial specimens were examined with electron microscopy， Western blot， quantitative RT-PCR， and terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling （TUNEL） assay. The experimental data were analyzed by SPSS 17.0. Student’s t test was employed for comparisons between two groups. Differences within groups at different time intervals were compared with repeated measures ANOVA. A two-tail