Chen Shou-Quan, Zhou Shi-Fang, Li Zhang-Ping, Zhang Jie, Yan Ping, Huang Wei-Jia, Cheng Jun-Yan, Li Hui-Ping, Wang Wan-Tie
Department of Emergency, The First Affiliated Hospital, Wenzhou Medical College, Wenzhou 325000, Zhejiang, China.
Zhongguo Wei Zhong Bing Ji Jiu Yi Xue. 2008 Dec;20(12):730-2.
To investigate the changes in serum creatine kinase isoenzyme (CK-MB) and cardiac troponin I (cTnI) levels and the ultrastructure of myocardium, and the effect of ulinastatin after cardiopulmonary resuscitation (CPR) in rats.
One hundred and twenty Sprague-Dawley (SD) rats were randomly divided into sham operation group, CPR group and ulinastatin group. And each group was divided into five subgroups (n=8) according to time points of 0.5, 3, 6, 12, 24 hours after tracheostomy in sham operation group or after restoration of spontaneous circulation (ROSC) in CPR group and ulinastatin group. Cardiac arrest (CA) and CPR models were reproduced by asphyxia in CPR group and ulinastatin group, with injection of ulinastatin 100 kU/kg via carotid 2 minutes after ROSC in ulinastatin group. Normal saline was given in the same dosage as ulinastatin in CPR group. Serum samples was taken at each time point of subgroups for measuring serum levels of CK-MB and cTnI. The ultrastructure changes in myocardium were observed under the electron microscope.
The serum levels of CK-MB and cTnI were increased from 0.5 hours after ROSC in CPR group and ulinastatin group compared with sham operation group ( all P<0.01), and CK-MB peaked at 12 hours, then decreased. The serum CK-MB or cTnI levels started to decreased from 3 hours or 0.5 hours after ROSC in ulinastatin group compared with CPR group (P<0.05 or P<0.01). There were milder pathological changes of ultrastructure of myocardium in ulinastatin group than in CPR group.
Ulinastatin could decrease serum levels of CK-MB and cTnI, and alleviate myocardial injury after CPR in rats.
探讨大鼠心肺复苏(CPR)后血清肌酸激酶同工酶(CK-MB)和心肌肌钙蛋白I(cTnI)水平变化、心肌超微结构改变以及乌司他丁的作用。
将120只Sprague-Dawley(SD)大鼠随机分为假手术组、CPR组和乌司他丁组。假手术组在气管切开术后,CPR组和乌司他丁组在自主循环恢复(ROSC)后,根据0.5、3、6、12、24小时时间点各分为5个亚组(n = 8)。CPR组和乌司他丁组采用窒息法建立心脏骤停(CA)和CPR模型,乌司他丁组在ROSC后2分钟经颈动脉注射100 kU/kg乌司他丁。CPR组给予与乌司他丁相同剂量的生理盐水。各亚组在相应时间点采集血清样本,检测血清CK-MB和cTnI水平。在电子显微镜下观察心肌超微结构变化。
CPR组和乌司他丁组ROSC后0.5小时血清CK-MB和cTnI水平较假手术组升高(均P < 0.01),CK-MB在12小时达峰值后下降。与CPR组相比,乌司他丁组ROSC后3小时或0.5小时血清CK-MB或cTnI水平开始下降(P < 0.05或P < 0.01)。乌司他丁组心肌超微结构病理改变较CPR组轻。
乌司他丁可降低大鼠CPR后血清CK-MB和cTnI水平,减轻心肌损伤。