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目的:探讨心肺复苏后大鼠血清神经元特异性烯醇化酶(NSE)的变化、大脑皮层病理改变及乌司他丁的干预作用。方法:成年雄性SD大鼠120只,随机分为假手术对照组、复苏组、乌司他丁组(药物组),每组按气管切开后(对照组)或自主循环恢复(ROSC)后(复苏组、药物组)0.5、3、6、12h和24h分为5个亚组(n=8)。复苏组和药物组采用窒息致大鼠心脏骤停和心肺复苏模型,药物组于ROSC后2min内经颈动脉推注乌司他丁(100000U/kg)。对照组仅行麻醉、气管切开和血管穿刺。各组分别于各时间点取血和组织标本,以ELISA法检测血清NSE浓度,光镜下观察大脑皮层的病理改变。结果:与对照组比较,复苏组和药物组ROSC后各亚组各时间点血清NSE含量明显升高(P<0.05或P<0.01);与复苏组比较,药物组ROSC后6、12、24h血清NSE含量显著降低(P<0.05或P<0.01)。药物组病理损害轻于复苏组。结论:乌司他丁通过降低血清NSE浓度对心肺复苏后脑损伤具有一定的保护作用。
Objective: To investigate the changes of serum neuron-specific enolase (NSE), pathological changes of cerebral cortex and intervention of ulinastatin in rats after cardiopulmonary resuscitation. Methods: 120 adult male Sprague-Dawley rats were randomly divided into sham operation control group, resuscitation group and ulinastatin group (drug group). After tracheotomy (control group) or spontaneous circulation recovery (ROSC) (Recovery group, drug group) were divided into 5 subgroups (n = 8) at 0.5, 3, 6, 12 h and 24 h. Rats in resuscitation and drug groups were treated with asphyxial cardiac arrest and cardiopulmonary resuscitation (CPR) models. Ulinastatin (100 000 U / kg) was given via carotid artery within 2 minutes after ROSC. Control group only anesthesia, tracheotomy and vascular puncture. The blood and tissue samples were taken from each group at different time points. Serum NSE concentration was measured by ELISA and the pathological changes of cerebral cortex were observed under light microscope. Results: Compared with the control group, the levels of serum NSE in each subgroup at each time point after ROSC resuscitation and drug groups were significantly increased (P <0.05 or P <0.01). Compared with the resuscitation group, Serum NSE levels were significantly lower (P <0.05 or P <0.01). The pathological damage of the drug group was lighter than that of the resuscitation group. Conclusion: Ulinastatin can protect brain injury after cardiopulmonary resuscitation by decreasing the concentration of serum NSE.