Liu Wenxun, Wang Yun, Zhou Xiaohong, Hai Kerong, Jia Danting, Ye Qingshan
Ningxia Medical University, Yinchuan, China.
Department of Anesthesiology, People's Hospital of Ningxia Hui Autonomous Region, Yinchuan, China.
Evid Based Complement Alternat Med. 2020 Sep 20;2020:8430746. doi: 10.1155/2020/8430746. eCollection 2020.
After a cardiac arrest (CA) of 5 to 10 min, a marked activation of blood coagulation occurs and microthrombi are found in the cerebral vessels. These microcirculatory disturbances directly affect the outcome on cardiopulmonary resuscitation (CPR). The purpose of this study was to investigate the effects and potential mechanisms of prophylactic anticoagulation on rat brain cells after cerebral CPR. After setting up an asphyxial CA model, we monitored the basic parameters such as the vitals and survival rate of the rats and assessed the respective neurological deficit (ND) and histological damage (HD) scores of their brain tissues. We, furthermore, investigated the influence of heparin on the expressions of TNF-, IL-1, CD40, NF-B, and HIF-1 after asphyxial CA. The results showed that anticoagulation with heparin could obviously improve the outcome and prognosis of brain ischemia, including improvement of neurological function recovery and prevention of morphological and immunohistochemical injury on the brain, while significantly increasing the success rate of CPR. Treatment with heparin significantly inhibited the upregulation of CD40, NF-B, and HIF-1 induced by asphyxial CA. Thrombolysis treatment may improve the outcome and prognosis of CPR, and future clinical studies need to evaluate the efficacy of early heparin therapy after CA.
在心脏骤停（CA）持续5至10分钟后，会发生明显的血液凝固激活，并且在脑血管中发现微血栓。这些微循环障碍直接影响心肺复苏（CPR）的结果。本研究的目的是探讨预防性抗凝对脑心肺复苏后大鼠脑细胞的影响及潜在机制。建立窒息性CA模型后，我们监测了大鼠的生命体征和存活率等基本参数，并评估了其脑组织各自的神经功能缺损（ND）和组织学损伤（HD）评分。此外，我们研究了肝素对窒息性CA后TNF-、IL-1、CD40、NF-κB和HIF-1表达的影响。结果表明，肝素抗凝可明显改善脑缺血的结果和预后，包括改善神经功能恢复以及预防脑的形态学和免疫组化损伤，同时显著提高CPR成功率。肝素治疗显著抑制了窒息性CA诱导的CD40、NF-κB和HIF-1的上调。溶栓治疗可能改善CPR的结果和预后，未来的临床研究需要评估CA后早期肝素治疗的疗效。
