Guo Zhi-Jun, Wu Cai-Jun, Li Chun-Sheng
Intensive Care Unit, Shandong Cancer Hospital and Institute, Jinan, 250117, China.
Department of Emergency, Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100020, China.
Chin J Integr Med. 2016 Jul;22(7):503-9. doi: 10.1007/s11655-015-2156-8. Epub 2015 Aug 11.
To compare the effect of Shen-Fu Injection (SFI) and epinephrine on the expression of sarcoplasmic reticulum Ca(2+) ATPase 2a (SERCA2a) in a pig model with post-resuscitation myocardial dysfunction.
Ventricular fibrillation (VF) was electrically induced in Wu-zhi-shan miniature pigs. After 8 min of untreated VF and 2 min of cardiopulmonary resuscitation (CPR), all animals were randomly administered a bolus injection of saline placebo (SA group, n=10), SFI (0.8 mg/kg, SFI group, n=10) or epinephrine (20 μg/kg, EPI group, n=10). After 4 min of CPR, a 100-J shock was delivered. If the defibrillation attempt failed to attain restoration of spontaneous circulation (ROSC), manual chest compressions were rapidly resumed for a further 2 min followed by a second defibrillation attempt. Hemodynamic variables were recorded, and plasma concentrations of catecholamines were measured. Adenylate cyclase (AC), cyclic adenosine monophosphate (cAMP) and the expressions of β1-adrenoceptor (AR) and SERCA 2a were determined.
Cardiac output, left ventricular dp/dtmax and negative dp/dtmax were significantly higher in the SFI group than in the SA and EPI groups at 4 and 6 h after ROSC. The expression of β1-AR and SERCA2a at 24 h after ROSC were significantly higher in the SFI group than in the SA and EPI groups (P<0.05 or P<0.01).
The administration of epinephrine during CPR decreased the expression of SERCA2a and aggravated postresuscitation myocardial function (P<0.01). SFI attenuated post-resuscitation myocardial dysfunction, and the mechanism might be related to the up-regulation of SERCA2a expression.
在复苏后心肌功能障碍的猪模型中,比较参附注射液(SFI)和肾上腺素对肌浆网Ca(2+)ATP酶2a(SERCA2a)表达的影响。
对五指山小型猪进行电诱导室颤(VF)。在未经处理的VF持续8分钟和心肺复苏(CPR)2分钟后,将所有动物随机给予静脉推注生理盐水安慰剂(SA组,n = 10)、SFI(0.8 mg/kg,SFI组,n = 10)或肾上腺素(20 μg/kg,EPI组,n = 10)。CPR 4分钟后,给予100焦耳电击。如果除颤尝试未能恢复自主循环(ROSC),则迅速恢复手动胸外按压2分钟,然后进行第二次除颤尝试。记录血流动力学变量,并测量血浆儿茶酚胺浓度。测定腺苷酸环化酶(AC)、环磷酸腺苷(cAMP)以及β1-肾上腺素能受体(AR)和SERCA 2a的表达。
ROSC后4小时和6小时,SFI组的心输出量、左心室dp/dtmax和负dp/dtmax显著高于SA组和EPI组。ROSC后24小时,SFI组的β1-AR和SERCA2a表达显著高于SA组和EPI组(P<0.05或P<0.01)。
CPR期间给予肾上腺素会降低SERCA2a的表达并加重复苏后心肌功能(P<0.01)。SFI减轻了复苏后心肌功能障碍,其机制可能与SERCA2a表达上调有关。