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参附注射液与肾上腺素对猪长时间心脏骤停模型中儿茶酚胺水平的比较。

Comparison of Shenfu Injection () and epinephrine on catecholamine levels in a porcine model of prolonged cardiac arrest.

作者信息

Zhang Da, Li Chun-Sheng, Guo Zhi-Jun, Yin Wen-Peng, Hou Xiao-Min

机构信息

Department of Emergency Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100020, China.

出版信息

Chin J Integr Med. 2016 May;22(5):370-6. doi: 10.1007/s11655-015-2077-6. Epub 2015 Mar 6.

Abstract

OBJECTIVE

To compare the effects of Shenfu Injection (SFI) and epinephrine (EPI) on catecholamine levels in a porcine model of prolonged cardiac arrest (CA).

METHODS

After 8 min of untreated ventricular fibrillation, 24 Wuzhishan miniature pigs were randomly assigned to one of the three groups (n=8 per group) and received central venous injection, respectively: SFI group (1 mL/kg), EPI group (20 μg/kg EPI), and normal saline (NS) group. Cardiac output (CO), maximum rate of increase/decrease in left ventricular pressure (±dp/dt), serum levels of EPI, norepinephrine (NE), and dopamine (DA) were determined at baseline and at 0.5, 1, 2, and 4 h after restoration of spontaneous circulation.

RESULTS

The duration of cardiopulmonary resuscitation was shorter in the EPI and SFI groups than in the NS group (P<0.05). The EPI level increased significantly after restoration of spontaneous circulation (ROSC) in all three groups, and was significantly different between the EPI group and the other two groups immediately after ROSC (both P<0.01), but these differences gradually disappeared over time. There were no significant differences in NE or DA levels among the three groups, and there were no correlations between catecholamine levels and CO or dp/dt (P>0.05).

CONCLUSIONS

SFI did not significantly affect endogenous catecholamine levels during cardiopulmonary resuscitation after prolonged ventricular fibrillation. However, SFI improved oxygen metabolism, and produced a better hemodynamic status compared with EPI. SFI might be a potentially vasopressor drug for the treatment of CA.

摘要

目的

比较参附注射液(SFI)和肾上腺素(EPI)对长时间心脏骤停(CA)猪模型儿茶酚胺水平的影响。

方法

在未经处理的室颤8分钟后,将24只五指山小型猪随机分为三组(每组n = 8),分别接受中心静脉注射:SFI组(1 mL/kg)、EPI组(20 μg/kg EPI)和生理盐水(NS)组。在基线以及自主循环恢复后0.5、1、2和4小时测定心输出量(CO)、左心室压力最大上升/下降速率(±dp/dt)、血清EPI、去甲肾上腺素(NE)和多巴胺(DA)水平。

结果

EPI组和SFI组的心肺复苏持续时间比NS组短(P<0.05)。三组自主循环恢复(ROSC)后EPI水平均显著升高,ROSC后即刻EPI组与其他两组有显著差异(均P<0.01),但这些差异随时间逐渐消失。三组之间NE或DA水平无显著差异,儿茶酚胺水平与CO或dp/dt之间无相关性(P>0.05)。

结论

在长时间室颤后的心肺复苏过程中,SFI对内源性儿茶酚胺水平无显著影响。然而,与EPI相比,SFI改善了氧代谢,并产生了更好的血流动力学状态。SFI可能是一种治疗CA的潜在血管升压药物。

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