Wang Jingao, Lin Jiyan, Zhang Minwei, He Yujing, Pan Xiaowen, Yang Chengbin, Cai Dongmei
Department of Emergency, the First Affiliated Hospital of Xiamen University, Xiamen 361003, Fujian, China. Corresponding author: Zhang Minwei, Email:
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2017 Oct;29(10):911-915. doi: 10.3760/cma.j.issn.2095-4352.2017.10.010.
To investigate the effects of hydrogen (H) on myocardium injury post-cardiac arrest (CA) in rabbits.
Sixty New Zealand rabbits were randomly divided into H treatment group (n = 30) and control group (n = 30) by random number table. The rabbit CA model was established by means of electrical stimulation of external membrane, both groups were mechanically ventilated. Cardiopulmonary resuscitation (CPR) was performed after 6 minutes of nonintervention, and stopped after restoration of spontaneous circulation (ROSC). Inhalation of 2% H gas was conferred to rabbits immediately at the end of CA modeling for 72 hours in H treatment group. Air was given to rabbits in control group instead. The survival rate of rabbits was analyzed. Heart rate, ventricular premature beat frequency, and the levels of blood samples cardiac troponin I (cTnI), left ventricular ejection fraction (LVEF), B-type natriuretic peptide (BNP), and blood lactic acid (Lac) were collected before CA and after ROSC in all rabbits. Rabbits were sacrificed and microstructure injury was observed by electric microscope after ROSC 72 hours.
There were 28 animals ROSC in both groups; the survival number in H treatment group was higher than that in control group at 72 hours after ROSC (number: 15 vs. 7, χ = 4.791, P = 0.029). In the early stage of ROSC, the heart rate of two groups slowed down, the number of premature ventricular increased, and then gradually recovered; the heart rate in H treatment group was returning to normal more quickly than that in control group at 48 hours after ROSC (bpm: 319±63 vs. 362±40, P < 0.05); the ventricular premature beat frequency was lower than that in control group at 72 hours after ROSC (times per minutes: 9.1±4.3 vs. 15.0±8.0, P < 0.05). The animals of two groups had different degrees of myocardial damage and cardiac insufficiency after ROSC, and restored with the extension of time. Compared with control group, the level of BNP in H treatment group was significant decreased at 24 hours after ROSC (ng/L: 385±98 vs. 488±174, P < 0.05), the levels of cTnI and Lac were significant decreased at 48 hours after ROSC [cTnI (μg/L: 1.83±0.68 vs. 2.83±0.98, Lac (mmol/L): 5.5±1.6 vs. 7.9±2.6, both P < 0.01], the LVEF was slightly higher than that at 72 hours after ROSC (0.690±0.040 vs. 0.650±0.041, P = 0.051). Compared with control group, less damage to myocardial ultra structure was found in H treatment group at 72 hours after ROSC.
Inhalation of H alleviates cardiac dysfunction and myocardial injury after CPR.
探讨氢气(H)对兔心脏骤停(CA)后心肌损伤的影响。
采用随机数字表法将60只新西兰兔随机分为H治疗组(n = 30)和对照组(n = 30)。通过体外膜电刺激建立兔CA模型,两组均进行机械通气。干预6分钟后进行心肺复苏(CPR),自主循环恢复(ROSC)后停止。H治疗组在CA建模结束后立即给予兔吸入2% H气体72小时,对照组给予空气。分析兔的存活率。收集所有兔CA前和ROSC后的心率、室性早搏频率以及血样中心肌肌钙蛋白I(cTnI)、左心室射血分数(LVEF)、B型利钠肽(BNP)和血乳酸(Lac)水平。ROSC 72小时后处死兔,电镜观察微观结构损伤。
两组均有28只动物实现ROSC;ROSC后72小时,H治疗组存活数高于对照组(数量:15只对7只,χ = 4.791,P = 0.029)。在ROSC早期,两组心率减慢,室性早搏数量增加,随后逐渐恢复;ROSC后48小时,H治疗组心率恢复正常的速度比对照组更快(bpm:319±63对362±40,P < 0.05);ROSC后72小时,室性早搏频率低于对照组(次/分钟:9.1±4.3对15.0±8.0,P < 0.05)。两组动物ROSC后均有不同程度的心肌损伤和心功能不全,并随时间延长而恢复。与对照组相比,ROSC后24小时H治疗组BNP水平显著降低(ng/L:385±98对488±174,P < 0.05),ROSC后48小时cTnI和Lac水平显著降低[cTnI(μg/L):1.83±0.68对2.83±0.98,Lac(mmol/L):5.5±1.6对7.9±2.6,均P < 0.01],ROSC后72小时LVEF略高于对照组(0.690±0.040对0.650±0.041,P = 0.051)。与对照组相比,ROSC后72小时H治疗组心肌超微结构损伤较小。
吸入氢气可减轻心肺复苏后心脏功能障碍和心肌损伤。