左西孟旦对脂肪乳剂复苏布比卡因所致大鼠离体心脏停搏的影响

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摘要目的：研究左西孟旦对脂肪乳剂复苏布比卡因所致离体心脏停搏效应的影响。方法：16只雄性SD大鼠，随机分为2组（n=8），采用Langendorff离体心脏装置，建立离体心脏布比卡因停搏模型。对照组：以2%脂肪乳剂进行灌流；实验组：采用5 μmol/L左西孟旦和2%脂肪乳剂进行灌流。观察复跳情况和复跳时间（Tr），记录复跳后40 min内心率（HR）、HR和左室发展压乘积（RPP）、左心室内压最大上升速率（+dp/dt）和冠脉流量（CF）以及心律失常情况。结果：2组离体心脏均复跳，Tr差异无统计学意义（P＞0.05）。与对照组比，实验组离体心脏复跳后40 min内的心功能参数HR、RPP和+dp/dt均较高，差异有统计学意义（P＜
0.05）；复跳后实验组中离体心脏的CF明显大于对照组，差异有统计学意义（P＜0.05）；2组均未出现室性心律失常。结论：在离体心脏布比卡因停搏模型上，左西孟旦有利于改善脂肪乳剂复苏后心功能和CF，不增加室性心律失常发生的风险。

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关键词 ：左西孟旦, 脂肪乳剂, 布比卡因, 心脏停搏, 复苏

Abstract：Objective: To investigate the effect of levosimendan on the resuscitation with lipid emulsion in bupivacaine-induced asystole in isolated rat hearts. Methods: Sixteen male Sprague-Dawley rats were randomly divided into two groups (n=8). Asystole was induced by bupivacaine in the Langendorff isolated heart perfusion model. The perfusate in the control group contained 2% lipid emulsion, while the perfusate in the experiment group contained levosimendan (5 μmol/L) and 2% lipid emulsion. The resuscitation time (Tr), heart rate (HR), heart rate-pressure product (RPP) , the maximum change rate of left ventricular pressure rise (+dp/dt) and coronary flow (CF) in the isolated hearts were all recorded until 40 min since the recovery phase. Results: All hearts in both groups achieved re-beating. Tr in two groups has no significant difference (P>0.05). Compared with the control group, the cardiac function parameter HR, RPP and +dp/dt increased significantly in the isolated heart of the experiment group during the 40 min recovery phase (P<0.05). CF of the heart in the experiment group was higher than that of the control group after re-beating (P<0.05). There were no ventricular arrhythmias in two groups. Conclusion: In the bupivacaine-induced asystole of isolated rat heart model, levosimendan can enhance the heart function without increasing the risk of ventricular arrhythmias after the resuscitation with lipid emulsion.

Key words： levosimendan lipid emulsion bupivacaine cardiac arrest resuscitation

收稿日期: 2017-01-13

基金资助:国家自然科学基金资助项目（81470419）；温州市科技局科研基金资助项目（Y20160373，Y20140702）。

通讯作者: 徐旭仲，教授，Email：xuzhong@263.net

作者简介: 夏芳芳（1988-），女，浙江温州人，住院医师，硕士

链接本文:

https://xb.wmu.edu.cn/CN/ 或 https://xb.wmu.edu.cn/CN/Y2017/V47/I7/496

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