摘要目的 比较两种不同复苏方法对心搏骤停兔心肌组织Fas,Fas-L及凋亡的影响.方法 分别采用膈肌下抬挤心脏复苏法与标准心肺复苏法对开腹手术中窒息致心搏骤停兔进行复苏,计算6 h存活率,榆测复苏成功6 h后心肌细胞Fas,Fas-L表达及凋亡,对比两组的不同.结果 膈肌下复苏组6 h存活率显著高于标准心肺复苏组,差异具有统计学意义(75%vs.25%,P＜0.05),心肌细胞Fas,Fas-L表达[Fas:(27.3±4.7)vs.(55.1±6.7);Fasl:(32.7±5.4)vs.(58.9±7.2)]及心肌细胞凋亡率显著低于标准心肺复苏组.差异具有统计学意义[(12.7±3.4)%V8.(22.5±5.2)%(P＜0.05)].结论 开腹手术发生心搏骤停时,膈肌下抬挤心脏复苏法较标准心肺复苏法心肌细胞Fas,Fas-L表达减少,心肌细胞凋亡减少,缺血.再灌注损伤程度减轻,6 h存活率提高.

abstractsObjective To compare two modalities of cardiopulmonary resuscitation (CPR) for cardiac arrest with regard to the expressions of Fas/Fas-L and apoptosis of cardiomyocytes. Method A total of rabbits were made into models of cardiac arrest (CA) by asphyxia during laparotomy and then divided equally into two groups as per different modalities of resuscitation employed, transdiaphragmatic heart massage (group A) and conventional heart massage (group B). These rabbits were sacrificed and cardiac tissues were taken out for determination of Fas/Fas-L expressions and apoptosis cardiac muscle cells 6 hours after successful resuscitation. The expressions of Fas/Fas-L were assayed with, and apoptotic cells were counted with. Results The survival rate within 6 hours af-ter successful resuscitation was higher in group A than that in group B (75% vs. 25%, P ＜ 0.05). The expres-sions of Fas/Fas-L [Fas: (27.3 ±4.7) vs. (55.1±6.7);Fasl: (32.7±5.4) vs. (58.9±7.2)] and rate of apoptotic cells [(12.7±3.4)% vs. (22.5±5.2)%] were lower in group A than those in group B(P＜0.05). Conclusions The transdiaphragmatic heart massage for resuscitation of cardiac arrest is more effective than con-ventional one that it is proved by higher survival rate, and lower rates of Fas/Fas-L expressions and apoptotic cells.