An experimental study on Huangqi injection associated with a combined treatment on protective effects of heart after cardiopulmonary resuscitation in rabbits / 中国中西医结合急救杂志

ABSTRACT

Objective To observe the effects of Huangqi injection associated with a combined treatment on changes of hemodynamics indexes and brain natriuretic peptide (BNP) after cardiopulmonary resuscitation (CPR) in rabbit models with cardiac arrest (CA) to elucidate the mechanism of such cardiac protective effects. Methods Twenty-four New Zealand rabbits were randomly divided into four groups(each,n=6). The CPR model in rabbits was reproduced by using extra-corporal electric shock method(put through 50 V alternating current to quiver on chest). The animals in operation control group were given anesthesia,all kinds of catheter inserted into the body and tracheotomy,but no induction of ventricular fibrillation. In the epinephrine group,epinephrine (30 μg/kg)was injected into the right jugular vein by a catheter during CPR. In the sub-hypothermia group, epinephrine(30μg/kg)was injected into the right jugular vein via a catheter and 0.9%sodium chloride under 4℃at a rate of 1.0 mL · kg-1 · min-1 was pumped into the ear marginal vein simultaneously with the chest external compressions during CPR and the cooling of body surface sustaining at the target temperature (32-34℃) for 4 hours until the end of the experiment. In the combined treatment group,Huangqi injection(4 g/kg)was injected into the right jugular vein on the basis of treatment of sub-hypothermia group. Hemodynamics indexes such as left ventricular end-diastolic pressure(LVEDP),the maximal rate of left ventricular pressure increase/decline(±dp/dt max),and the mean arterial pressure(MAP)were dynamically monitored at 15 minutes before inducing ventricular fibrillation and at the early stage of post resuscitation for 30,60,120,180,240 minutes,and in the mean time the concentration of BNP was dynamically monitored at 15 minutes before inducing ventricular fibrillation and at the early stage of post resuscitation for 30,180,240 minutes. Results Compared with those of the operation control group,the levels of LVEDP and BNP of epinephrine,sub-hypothermia and combined treatment groups were gradually increased obviously,while ±dp/dt max and MAP were decreased significantly after successful CPR. The levels of LVEDP and BNP at any time point in the combined treatment group were markedly less than those of the epinephrine and sub-hypothermia groups,and along with the time extension,the level of LVEDP had a tendency of elevation,and the level of BNP had a tendency of gradual decrease,reaching peak and valley values respectively at 240 minutes after CPR〔LVEDP (mmHg,1 mmHg=0.133 kPa)6.56±0.21 vs. 12.57±0.33,9.54±0.24,BNP(ng/L)199±19 vs. 286±14, 251±29,all P<0.01〕,at each time point,the ±dp/dt max and MAP levels were significantly higher than those in epinephrine and sub-hypothermia groups,and they were gradually decreased with the time prolongation,reaching valley values at 240 minutes after CPR〔+dp/dt max(mmHg/ms)4 229±353 vs. 2 055±311,3 224±158,-dp/dt max(mmHg/ms)3 587±168 vs. 1 315±189,2 357±245,MAP(mmHg)82.02±1.81 vs. 44.15±1.17, 56.79±1.60,all P<0.01〕. Conclusion Huangqi injection associated with a combined treatment has obvious protective effects on heart after CPR in rabbits,and the mechanism may be related to improvement of hemodynamics indexes and inhibition of excessive expression of BNP.