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目的探讨艾司洛尔混合肾上腺素对心肺复苏后大鼠心肌的保护作用。方法66只雄性Wistar大鼠随机分为3组(n=22),假手术组(Sham组)：不进行窒息和复苏；肾上腺素组(AD组)；肾上腺素+艾司洛尔(AD+ES)组。吸入4%异氟醚麻醉诱导,气管切开后机械通气,吸入1%～1．5%异氟醚维持麻醉,机械通气10 min时静脉注射维库溴铵0．01 mg/100 g,5 min后断开呼吸机致窒息,10 min后进行心肺复苏。用动脉血(1ml/100 g)、肝素(50 U/100 g)、碳酸氢钠(0．1 mEq/100 g)和肾上腺素(4μg/100 g),或混合艾司洛尔(100μg/100 g)制成“复苏合剂”。左股动脉置管用于测压,右股动脉置管至主动脉弓用于复苏时给药。AD组、AD+ES组在自主循环恢复(复苏)后30、120、180min分别处死6只大鼠,取心肌,电镜下观察心肌的超微结构。并测定线粒体ATP酶活性。复苏后持续监测心电图、心率(HR)、平均动脉压(MAP)。结果与Sham组比较,AD组复苏后10～180min时HR增快,AD+ES组仅在复苏后5 min时HR一过性增快,AD组、AD+ES组复苏后心肌线粒体Na~+-K~+-ATP酶、Ca~(2+)- ATP酶活性降低(P＜0．05或0．01)；与AD组比较,AD+ES组复苏后10～180min时HR降低,上述两种酶的活性升高(P＜0．05)。AD+ES组复苏后心肌的损伤均轻于AD组。结论艾司洛尔混合肾上腺素对心肺复苏后大鼠心肌有一定的保护作用,升高了线粒体ATP酶活性。
Objective To investigate the protective effect of esmolol mixed epinephrine on cardiomyocytes in rats after cardiopulmonary resuscitation. Methods Sixty-six male Wistar rats were randomly divided into 3 groups (n = 22): sham operation group (Sham group): no asphyxia and resuscitation; adrenaline group (AD group); adrenaline plus esmolol (AD + ES) group. Inhaled 4% isoflurane anesthesia induction, mechanical ventilation after tracheotomy, inhalation of isoflurane 1% to 1.5% to maintain anesthesia, intravenous vecuronium 0.01 mg / 100 g, 5 Respiratory apnea caused by disconnection of the min, cardiopulmonary resuscitation after 10 min. Heparin (50 U / 100 g), sodium bicarbonate (0.1 mEq / 100 g) and epinephrine (4 μg / 100 g), or esmolol (100 μg / 100 g) made of “resuscitation mixture.” Left femoral artery catheter for manometry, right femoral artery catheterization to the aortic arch for resuscitation. AD rats and AD + ES rats were sacrificed 30, 120 and 180 minutes after spontaneous circulation recovery (resuscitation) respectively. Six rats were sacrificed, and myocardial ultrastructure was observed under myocardial and electron microscope. Mitochondrial ATPase activity was measured. After recovery, electrocardiogram, heart rate (HR) and mean arterial pressure (MAP) were monitored continuously. Results Compared with Sham group, the HR of 10 ~ 180min after resuscitation in AD group was faster than that in Sham group. HR increased rapidly only 5 minutes after resuscitation in AD + ES group. In mitochondrial Na + (P <0.05 or 0.01). Compared with the AD group, the HR of the AD + ES group decreased 10 ~ 180min after resuscitation, The activities of the two enzymes increased (P <0.05). The myocardial damage in AD + ES group was lighter than that in AD group. Conclusion Esmolol combined with epinephrine may have a protective effect on myocardium after cardiopulmonary resuscitation and increase mitochondrial ATPase activity.