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目的:探讨吸入外源性H_2S对心跳骤停复苏大鼠脑血流动力学及神经功能的影响。方法:选择成年雄性SD大鼠18只,随机分为假手术组(sham,n=6)、窒息导致心跳骤停复苏组(CA,n=6)、心跳骤停复苏+H_2S组(H_2S,n=6),观察H_2S对心跳骤停复苏大鼠脑血流的影响。选择成年雄性SD大鼠45只,随机分为sham组(n=5)、CA(n=20)和H_2S组(n=20),观察H_2S对心跳骤停复苏大鼠神经功能和存活率的影响。结果:CA组与H_2S组在ROSC后MAP和CPP均快速上升,远高于基础值(P<0.05);而后两组MAP和CPP均缓慢下降,实验结束时,明显低于基础值(P<0.05)。两组间比较差异无统计学意义(P>0.05)。CA组与H_2S组CBF曲线在ROSC后上升至峰值,随后逐渐下降,两组在峰值无明显差异,但H_2S组CBF减少量显著少于CA组(P<0.05)。而在CVR曲线,在实验最后,CA组CVR值仍明显高于基础值(P<0.05),而H_2S组基本降至基础值,明显低于CA组(P<0.05)。H_2S组的14天存活率(80%)明显高于CA组(50%,P<0.05)。在胶带移除实验(tape removal test,TRT)所需时间上,CA组与H_2S组在第1天、第3天及第14天都存在显著差异(P<0.05)。H_2S组第14天海马CA1区神经元存活数(33±8)明显多于CA组(20±6,P<0.05),但仍较假手术组少(53±10,P<0.05)。结论:外源性H_2S吸入对大鼠心跳骤停复苏后MAP及CPP无明显影响。外源性H_2S通过降低CVR,改善CBF,从而改善大鼠心跳骤停复苏后的脑循环。外源性H_2S能明显提高心跳骤停复苏后大鼠的存活率,降低TRT所需时间,同时显著增加海马CA1区神经元的存活,改善大鼠心跳骤停复苏后神经功能转归。
Objective: To investigate the effects of exogenous H 2 S inhalation on cerebral hemodynamics and neurological function in rats after cardiac arrest and resuscitation. Methods: Eighteen male Sprague Dawley rats were randomly divided into sham group (n = 6), asphyxia group (CA, n = 6), cardiac arrest resuscitation group n = 6). The effect of H 2 S on cerebral blood flow in resuscitation rats with cardiac arrest was observed. Forty-five male Sprague-Dawley rats were randomly divided into sham group (n = 5), CA (n = 20) and H 2 S group (n = 20), and the neurological function and survival rate influences. Results: Both MAP and CPP in CA and H 2 S groups increased rapidly after ROSC, which was much higher than the baseline value (P <0.05). However, MAP and CPP in both groups decreased slowly at the end of the experiment (P < 0.05). There was no significant difference between the two groups (P> 0.05). CBF curve between CA group and H 2 S group increased to peak value after ROSC, and then decreased gradually. There was no significant difference between two groups in peak value of CBF, but the reduction of CBF in H 2 S group was significantly less than that in CA group (P <0.05). In the CVR curve, the CVR of CA group was still significantly higher than that of baseline (P <0.05) at the end of the experiment, while that in H 2 S group was basically lower than that of CA group (P <0.05). The 14-day survival rate (80%) in H_2S group was significantly higher than that in CA group (50%, P <0.05). At the time required for tape removal test (TRT), there was a significant difference (P <0.05) between the CA group and the H 2 S group on the 1st day, the 3rd day and the 14th day. The number of neurons in hippocampal CA1 subfield in H_2S group was significantly higher than that in CA group on day 14 (20 ± 6, P <0.05), but still lower than that in sham group (53 ± 10, P <0.05). Conclusion: Exogenous H 2 S inhalation has no obvious effect on MAP and CPP after cardiac arrest and resuscitation in rats. Exogenous H 2 S improves the cerebral circulation after cardiac arrest and resuscitation in rats by decreasing CVR and improving CBF. Exogenous H 2 S can significantly improve the survival rate of rats after cardiac arrest and resuscitation, reduce the time required for TRT, significantly increase the survival of neurons in hippocampal CA1 area and improve the neurological outcome after cardiac arrest and resuscitation in rats.