摘要目的 研究联用选择性α_2-肾七腺素能受体激动剂米伐西醇(mivazerol)和k-阿片受体激动剂U50488H对心肺复苏后兔血流动力学和B型利钠肽(B-type natriuretic peptide,BNP)的影响,探讨防治复苏后心功能不全的有效方法.方法 于兰州大学医学院机能实验室,30只健康清洁家兔随机分为5组:肾上腺索组(E)、血管加压素组(V)、U50488H组(U)、米伐西醇组(M)、米伐两醇+U50488H组(M+U),建立心肺复苏模型(接通50 v交流电胸壁致颤),心肺复苏期间各组动物分别静注上述药物(自主循环恢复标准:恢复室上性心律,MAP≥60 mmHg持续5 min).于诱发室颤前15 min、复苏后30 min,60 min,120 min,180 min,240 min,动态监测血流动力学指标和心功能不全标志物BNP的浓度.统计学处理采用方差分析.结果 (1)M+U组复苏后MAP、peak-dp/dt、Peak+dp/dt各时间段值明显高于其余四组,LVEDP 上升幅度明显小于其余四组(均P<0.05).(2)复苏后,M+U组BNP各时间段浓度明显低于其余四组,与E,v,u组筹异具有统计学意义(P<0.01),与M组相比,差异具有统计学意义(P<0.05).结论 联用米伐两醇和U50488H可改善复苏后血流动力学指标,减少复苏后早期BNP的分泌,改善复苏后心功能小全.

abstractsObjective To investigate the effects of α_2-adrenergic receptor agonist and k-opioid receptor agonist jointly used on hemodynamics and B-type natriuretic peptide in rabbits,and to explore the effective methods for lessensing post-resuscitation myocardial dysfunction.Method After the establishment of cardiopulmonary resuscitation (CPR) model in rabbits, 30 rabbits were randomly divided into 5 groups, namely epinephrine group(E), vasopressin group(V), U50488H group(U), mivazerol group(M) and mivazerol + U50488H group(M + U). Hemodynamics and B-type natriuretic peptide were examined before ventricular fibrillation and in the early stage of post CPR (30-240 min). Statistical analysis was performed with ANOVA techniques. Results (1)MAP,peak - dp/dt and peak + dp/dt in M + U group were significantly higher than those in other groups, and the increase of LVEDP was less than that in other groups (P<0.05).(2)The concentration of BNP in M + U group was significantly decreased than that in other groups (P <0.01 or P <0.05). Conclusions The α_2-adrenergic receptor agonist (mivazerol) and k-opioid receptor agonist used together can improve post CPR hemodynamics and reduce the concentration of B-type natriuretic peptide, lessening the post CPR myocardial dysfunction.