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目的:探讨山莨菪碱对心脏骤停患者氧化应激及心肺复苏效果的影响。方法:选择急诊科抢救的心脏骤停患者119例,骤停时间≤10min,随机分为对照组和干预组。两组均按照美国心脏学会心肺复苏指南进行标准的心肺复苏,干预组在标准心肺复苏基础上静脉注射山莨菪碱,比较两组患者自主循环恢复(ROSC)率及复苏后24h存活率;分别在自主循环恢复后和复苏24h后测定血清总超氧化物岐化酶(T-SOD)活力、总抗氧化力(T-AOC)和丙二醛(MDA)含量,比较两组间差别。结果:干预组患者自主循环恢复率与对照组比较差异无统计学意义(P>0.01);复苏24h后,干预组患者存活率显著高于对照组(P<0.01);自主循环恢复后及复苏24h后,干预组T-SOD活力和T-AOC显著高于对照组,MDA含量显著低于对照组(P<0.01)。结论:早期应用山莨菪碱可能会减轻心脏骤停患者体内氧化应激,可能有助于提高复苏后24h存活率,但对于短期自主循环的恢复可能没有明显改善。
Objective: To investigate the effect of anisodamine on oxidative stress and cardiopulmonary resuscitation in patients with cardiac arrest. Methods: A total of 119 cases of sudden cardiac arrest were selected from emergency department. The time of arrest was ≤10 minutes and were randomly divided into control group and intervention group. Standard cardiopulmonary resuscitation was performed in both groups according to the American Heart Association guidelines for cardiopulmonary resuscitation. The intervention group received intravenous anisodamine on the basis of standard cardiopulmonary resuscitation. The rate of spontaneous circulation recovery (ROSC) and the survival rate after 24h of resuscitation were compared between the two groups. Twenty-four hours after resuscitation and 24 hours after resuscitation, the levels of total superoxide dismutase (T-SOD), total antioxidant capacity (T-AOC) and malondialdehyde (MDA) Results: The recovery rate of spontaneous circulation in the intervention group was not significantly different from that in the control group (P> 0.01). The survival rate of the intervention group was significantly higher than that of the control group after resuscitation (P <0.01) After 24 hours, T-SOD activity and T-AOC in intervention group were significantly higher than those in control group, MDA content was significantly lower than that in control group (P <0.01). Conclusions: Early use of anisodamine may reduce oxidative stress in patients with cardiac arrest, which may help to improve the survival rate after 24h of resuscitation, but may not improve the short-term recovery of spontaneous circulation.