复苏早期应用氨茶碱对腺苷及血管活性因子的影响

目的： 观察心搏骤停大鼠复苏早期应用氨茶碱对复苏成功率、血浆去甲肾上腺素(NE)、腺苷、一氧化氮(NO)水平及心肌组织内皮素-1(ET-1)、腺苷水平的影响。方法: 选60只SD大鼠，随机分为3组：手术对照组、肾上腺素治疗组和肾上腺素+氨茶碱治疗组各20只。分别测定治疗组自主循环恢复30 min后及手术对照组的血浆NE、腺苷、NO及心肌组织ET-1、腺苷的水平。结果: 肾上腺素+氨茶碱治疗组自主循环恢复时间明显少于肾上腺素治疗组(P＜0.05)。肾上腺素+氨茶碱治疗组自主循环恢复率为75%，30 min存活率为70%，肾上腺素治疗组分别为60%和55% (P>0.05)。2个治疗组自主循环恢复大鼠的血浆腺苷、NE水平及心肌组织ET-1、腺苷水平均明显高于手术对照组(P<0.05)，肾上腺素治疗组血浆NO水平也显著高于手术对照组(P＜0.01)，肾上腺素+氨茶碱治疗组血浆NO及心肌组织ET-1水平低于肾上腺素治疗组(P＜0.05)。结论: 在复苏早期应用腺苷受体拮抗剂氨茶碱不仅可提高复苏成功率，并且降低血浆NO和心肌组织ET-1水平，有利于减轻复苏后综合征。

Effects of aminophylline used in the early stage of resuscitation on adenosine and vaso-active factors

AIM: To investigate the effects of aminophylline used early in resuscitation on achievement ratio of resuscitation, the concentrations of plasma norepinephrine (NE), adenosine and nitric oxide (NO), and the levels of cardiac tissue endothelin-1 (ET-1) and adenosine in rats with sudden cardiac arrest. METHODS: Sixty SD rats were randomly divided into three groups: operated control (group A), epinephrine treatment (group B), and epinephrine plus aminophylline treatment (group C). Each group had 20 rats. The concentrations of plasma NE, adenosine and NO, and the levels of cardiac tissue ET-1 and adenosine were examined in group A and 30 min after survived in group B and group C. RESULTS: The duration of circulation recovered in group C was less than that in group B, significantly (P＜0.05). The rate of return of spontaneous circulation and survival to 30 min was achieved in 75% and 70% in group C, while those were achieved in 60% and 55% in group B, respectively (P>0.05). The concentrations of plasma adenosine and NE, and the levels of cardiac tissue ET-1 and adenosine in group B and group C were higher than those in group A significantly (P<0.05). The concentration of NO in group B was also higher than that in group A (P<0.01). The levels of plasma NO and cardiac tissue ET-1 in group C was lower than those in group B significantly (P＜0.05). CONCLUSION: Aminophylline as adenosine receptor antagonist used early in resuscitation not only increases the achievement ratio of resuscitation, but also decreases the levels of ET-1 and NO, so improves after-resuscitation syndrome.