乌司他丁对心肺复苏后家猪脑功能保护作用.docVIP

乌司他丁对心肺复苏后家猪脑功能保护作用 　　【摘要】目的 通过制作猪心肺复苏动物模型，于复苏后应用乌司他丁（UTI），评价其对心肺复苏后脑保护的作用。方法 雌性家猪20头，通过程控刺激法制作心室颤动动物模型，室颤8 min后开始心肺复苏，恢复自主循环的家猪随机（随机数字法）分为两组：①UTI组，复苏后立即开始给予UTI，每次10万U溶于生理盐水5 ml，缓慢注射，每3 h 1次，直到复苏后24 h（第24小时不给药）；②对照组，复苏后应用生理盐水5 ml作为对照，给药时间和次数同实验组。分别于基础状态、复苏后即刻、复苏后3、12及24 h抽取家猪静脉血备用测定TNF-α和IL-1β水平。复苏后24 h行神经功能评分（CPC评分），然后处死家猪，留取脑组织进行普通光镜病理及超微结构检查。结果 20头家猪经过8 min心室颤动后复苏成功15头。复苏后UTI组（n=8）和对照组（n=7）实验猪均存活24 h。复苏后3、12和24 h UTI组的TNF-α和IL-1β水平明显低于对照组（均P 　　【关键词】心肺复苏；乌司他丁；炎症因子；CPC评分；脑保护；猪 　　Effects of ulinastatin on brain protection after cardiopulmonary resuscitation in a porcine model WU Jun-yuan， WANG Shuo， LI Chun-sheng， YUAN Wei. Emergency Department， Beijing Chaoyang Hospital， Capital Medical University， Beijing 100020， China 　　Corresponding author： LI Chun-sheng，Email：lcscyyy@ 　　【Abstract】Objective To evaluate the effects of ulinastatin （UTI） on brain protection after cardiopulmonary resuscitation in a porcine model. Methods A total of 20 female swine were induced to make ventricular fibrillation（VF） by programmed stimulation method， and CPR was stared after 8 mins after VF. Swine after ROSC （return of spontaneous circulation） were randomly（random number） divided into two groups，namely UTI group and control group. In UTI group， UTI was administered slowly in a dose of 100 000 U dissolved in 5 ml saline immediately after resuscitation and then given every 3 h until 24 h after CPR （UTI not given at the time of 24 h）； and 5 ml saline was used instead in control group. Venous blood samples were taken separately before VF， immediate after resuscitation and 3 h， 12 h and 24 h after ROSC for detecting levels of TNF-α and IL-1β. Cerebral performance category （CPC） scores were assessed 24 h after ROSC， and subsequently the swine were sacrificed to get brain specimens for histopathological and ultrastructural examination under ordinary light microscope. Results Fifteen of twenty domestic swine were successfully rescued 8 mins after ventricular fibrillation. Swine of UTI grou