超短效β受体阻滞剂对兔复苏后心功能不全和B型脑钠肽作用研究
|
摘要
目的:复苏后心功能不全是成功现场心肺复苏后导致高死亡率的主要原因。B型脑钠肽是机体血液动力学发生改变时由心室释放的一种肽类激素,这种因子可以对左心功能进行评价。本室颤动物模型的实验研究目的是探讨超短效β受体阻滞剂对复苏后早期心功能和血浆B型脑钠肽浓度变化的影响。
方法:对18只试验用兔,随机分为3组,手术对照组进行室颤前全部操作,心脏骤停兔子模型分别应用肾上腺素或用肾上腺素前进行艾司洛尔预处理治疗,在室颤发生前和复苏成功后30—240分钟内的不同时间点进行血流动力学和血浆B型脑钠肽浓度指标的测量。
结果:复苏后兔心功能均呈现显著的、进行性减退。左室peak+dp/dt值在复苏后30分钟下降至基础值的57.1%,在120分钟时降至基础值的33.7%。艾司洛尔组兔左室peak+dp/dt值和单用肾上腺素组之间存在显著差异(P<0.01),左室peak-dp/dt值在上述两组间的检测时间点同样也出现显著差异(P<0.01)。两治疗组的左室舒张末压值在各采集时间点均较手术对照组有显著升高,并且两治疗组的LVEDP数据存在显著性差异(P<0.01)。两治疗组和手术组进行比较,在全部观察期间的血浆B型脑钠肽指标均明显增高,且两组间存在显著差异(P<0.01)。
结论:在对室颤导致的心脏骤停进行复苏时,应用短效β受体阻滞剂可以改善复苏后心功能不全,并可降低复苏早期B型脑钠肽的浓度。
Objective: Postresuscitation myocardial dysfunction contributes to the high fatality rate following successful resuscitation. B-type natriuretic peptide (BNP) is the cytokine released from the ventricles of the heart in response to hemodynamic stress, and is known to assess the left ventricular dysfunction. The purpose of this animal research was to investigate the effects of short-acting β -adrenergic blocker on the changes of cardiac function and concentration of BNP in the plasma during the early stage after cardiopulmonary resuscitation(CPR) from sudden cardiac arrest(CA) attributable to ventricular fibrillation(VF ).Methods: Treated with epinephrine or epinephrine with esmolol pretreatment, Hemodynamic values and concentration of BNP were measured in eighteen anesthetized rabbits, twelve rabbits were performed CA from VF, and at different time points during the early stage of postresuscitation period (30-240 min).Results: The left cardiac function was significantly reduced and progressively declined in all rabbits during the early stage of postresuscitation period;the peak positive first derivative of left ventricular pressure (Peak + dp/dt) was significantly decreased to 57.1% of baseline at 30 min, 33.7 % of baseline at 120 min in only epinephrine group. And peak + dp/dt in the epinephrine with esmolol-pretreatment group was significantly different from
the epinephrine-treatment group. The peak negative first derivative of left ventricular pressure (Peak-dp/dt) also differed significantly between the two study groups. The left ventricular end-diastolic pressure (LVEDP) showed a marked rise in the two treatment -groups at all time points, and there was significantly different between epinephrine-treated group and epinephrine with esmolol-pretreated group. In both treatment-groups, the BNP concentrations in plasma were detected higher than control group throughout the observation period. The increases in measured BNP concentrations could be observed at each postresuscitation time intervals, and the differences of the BNP concentrations weie significant between the two treatment-groups during the observation period.Conclusion : A short-acting P -adrenergic blocker administered immediately during resuscitation improved postresuscitation myocardial dysfunction, and reduced the concentration of BNP during the early postresuscitation period after CPR from CA.
方法:对18只试验用兔,随机分为3组,手术对照组进行室颤前全部操作,心脏骤停兔子模型分别应用肾上腺素或用肾上腺素前进行艾司洛尔预处理治疗,在室颤发生前和复苏成功后30—240分钟内的不同时间点进行血流动力学和血浆B型脑钠肽浓度指标的测量。
结果:复苏后兔心功能均呈现显著的、进行性减退。左室peak+dp/dt值在复苏后30分钟下降至基础值的57.1%,在120分钟时降至基础值的33.7%。艾司洛尔组兔左室peak+dp/dt值和单用肾上腺素组之间存在显著差异(P<0.01),左室peak-dp/dt值在上述两组间的检测时间点同样也出现显著差异(P<0.01)。两治疗组的左室舒张末压值在各采集时间点均较手术对照组有显著升高,并且两治疗组的LVEDP数据存在显著性差异(P<0.01)。两治疗组和手术组进行比较,在全部观察期间的血浆B型脑钠肽指标均明显增高,且两组间存在显著差异(P<0.01)。
结论:在对室颤导致的心脏骤停进行复苏时,应用短效β受体阻滞剂可以改善复苏后心功能不全,并可降低复苏早期B型脑钠肽的浓度。
Objective: Postresuscitation myocardial dysfunction contributes to the high fatality rate following successful resuscitation. B-type natriuretic peptide (BNP) is the cytokine released from the ventricles of the heart in response to hemodynamic stress, and is known to assess the left ventricular dysfunction. The purpose of this animal research was to investigate the effects of short-acting β -adrenergic blocker on the changes of cardiac function and concentration of BNP in the plasma during the early stage after cardiopulmonary resuscitation(CPR) from sudden cardiac arrest(CA) attributable to ventricular fibrillation(VF ).Methods: Treated with epinephrine or epinephrine with esmolol pretreatment, Hemodynamic values and concentration of BNP were measured in eighteen anesthetized rabbits, twelve rabbits were performed CA from VF, and at different time points during the early stage of postresuscitation period (30-240 min).Results: The left cardiac function was significantly reduced and progressively declined in all rabbits during the early stage of postresuscitation period;the peak positive first derivative of left ventricular pressure (Peak + dp/dt) was significantly decreased to 57.1% of baseline at 30 min, 33.7 % of baseline at 120 min in only epinephrine group. And peak + dp/dt in the epinephrine with esmolol-pretreatment group was significantly different from
the epinephrine-treatment group. The peak negative first derivative of left ventricular pressure (Peak-dp/dt) also differed significantly between the two study groups. The left ventricular end-diastolic pressure (LVEDP) showed a marked rise in the two treatment -groups at all time points, and there was significantly different between epinephrine-treated group and epinephrine with esmolol-pretreated group. In both treatment-groups, the BNP concentrations in plasma were detected higher than control group throughout the observation period. The increases in measured BNP concentrations could be observed at each postresuscitation time intervals, and the differences of the BNP concentrations weie significant between the two treatment-groups during the observation period.Conclusion : A short-acting P -adrenergic blocker administered immediately during resuscitation improved postresuscitation myocardial dysfunction, and reduced the concentration of BNP during the early postresuscitation period after CPR from CA.
引文
1.邵孝鉷.急诊学--基础理论与临床实践.北京:中国协和医科大学出版社,2004:73-124
2. The American Heart Association in collaboration with the international Liaison Committee on Resuscitation. Guidelines 2000 for Cardiopulmonary Resuscitation and Emergency Cardiovascular care[J]. Circulation. 2000;8(suppl): Ⅰ- 129-Ⅰ-135.
3.刘大为.危重病医学.北京:中国协和医科大学出版社,2000:5—50
4.邵孝鉷.急诊医学.北京:中国协和医科大学出版,2001:3—9
5.武建军、李利华、张颖丽等.大鼠心脏停搏期间心脏和肾脏α_1—肾上腺素能受体的变化[J] ,中国危重急救医学,1997:8 (9):456—462
6.王其新.现代临床急救进展.北京:人民军医出版社,2003:1—20
7. William C Shoemakrer, Stepen M , Ayres, Ake Grenvik, Peter R. Holbrook : Textbook of Critical Care(4th Edition), Harcourt Publishers International Company, 2001: 9—258
8. Haas T , Voelckel WG , Wenzel V , et al. Revisiting the cardiac versus thoracic pump mechanism during cardiopulmonary resuscitation [J]. Resuscitation, 2003 , 58 (1) : 113 - 116
9. Berg R, Hilwig RW, Ewy GA , et al. Precountershock cardiopulmonary resuscitation improves initial response to defibrillation from prolonged ventricular fibrillation : A randomized , controlled swine study[J] . Crit Care Med , 2004 , 32 (6) : 1352-1357
10. Frascone RJ, Bitz D, Lurie K. Combination of active compression decompression cardiopulmonary resuscitation and the inspiratory impedance threshold device: state of the art[J] . Curr Opin Crit Care, 2004, 10(3) : 193 - 201
11.高瑞,奚万山,陈伟宏等.大剂量肾上腺素对心肺复苏大鼠心肌超微结构的影响.中国危重病急救医学 1998;11 (10):648—652
12. Tommaso Pellis , Max Harry Weil , Wanchun Tang , et al. Evidence Favoring the Use of α_2-Selective Vasopressor Agent for Cardiopulmonary Resuscitation[J]. Circulation. 2003;11: 2716—2721
13. Lindner KH , Haak T , Keller A , et al. Release of endogenous vasopressors during and after cardiopulmonary resuscitation[J] . Heart, 1996, 75(2): 145-150
14. Krismer AC, Lindner KH, Wenzel V, et al. The effects of endogenous and exogenous vasopressin during experimental cardiopulmonary resuscitation. [J] Anesth Analg , 2001 , 92(6) : 1499 - 1504
15. Lindner KH, Prengel AW, Pfenninger EG, et al Vasopressin improves vital organ blood flow during closed - chest cardiopulmonary resuscitation in pigs[J] . Circulation , 1995 , 91 (1) : 215 - 221
16. Wenzel V, Lindner KH, Prengel AW, et al . Vasopressin improves vital organ blood flow after prolonged cardiac arrest with postcountershock pulseless electrical activity in pigs[J]. Crit Care Med , 1999 , 27(3) : 486 - 492
17. Strohmenger HU , Lindner KH , Keller A , et al . Effects of graded doses of vasopressin on median fibrillation frequency in a porcine model of cardiopulmonary resuscitation : results of a prospective, randomized, controlled trial[J] . Crit Care Med , 1996 , 24(8) : 1360 - 1365
18. Tusneyoshi I, Kanmura Y, Yoshimura N. Nitric oxide as a mediator of reduced arterical responsiveness in septic patients[J]. Crit Care Med, 1996, 24: 1083 - 1086
19.孟庆义,杜捷夫,沈洪等,氨茶碱在肾上腺素无效的心跳骤停患者中应用的初步研究[J].中国急救医学,2001,21(4):218—220
20. Dorrian P, Cass D, Schwart B, Cooper R, et al. Amiodarone as compared with lidocaine for shock-resistant fibrillation. N Engl J Med 2002;346(12): 884-890
21. Peter J, Kudenchuk, Gelaznikas R, et al. Amiodarone in out of hospital resuscitation of refractory sustained ventricuar tachyarrhythmias, N Engl J Med, 1999;341: 871-878
22. The hypothermia after cardiac arrest study group. Mild thcrapcutic hypothermia to improve the neurologic outcome after cardiac arrest[J] . N Engl J Med, 2002, 346(8) : 549 - 556
23. Jie Wei, Ling-LiLi, TaoLi. Protective effects of different sub-hypothermia methods on brain in rabbits after cardiopulmonary resuscitation[J]. 中国临床康复,2004;8:5442-5443
24. Bernard SA, Gray TW, Buist MD , et al. Treatment of comatose survivors of out-of-hospital cardiac arrest with induced hypothermia[J] . N Engl J Med , 2002 , 346 (8) : 557 - 5631
25. Bahringer W, Safar P , Wu X, et al. Survival without brain damage after clinical death of 60 - 120mins in dogs using suspended animation by profound hypothermia[J] . Crit Care Med , 2003 , 31 (5) : 1592 - 15931
26. Fischer M, Hossmann KA. No - reflow after cardiac arrest[J] . Intensive Care Med , 1995 , 21: 132 - 141.
27. Fischer M, Bottiger BW, Popov Cenic S , et al . Thrombolysis using plasminogen activator and heprin reduces cerebral no - reflow artery resuscitation from cardiac arrest : an experimental study in the cat[J]. Intensive Care Med , 1996 , 22: 1214 - 1223.
28. Gando B, Nanzaki S, Morimoto Y, et al . Tissue factor and tissue factor pathway inhibitor levels during and after cardiopulmonary resuscitation[J]. Thromb Res , 1999 , 96: 107 - 113.
29. Janata K, Holzer M, Kurkciyan I , et al. Major bleeding complication in cardiopulmonary resuscitation : the place of thrombolytic therapy in cardiac arrest due to massive pulmonary embolism[J] . Resuscitation , 2003 , 57(1) : 49 - 55.
30.康舟军.心肺复苏药物治疗新进展[J].中国急救医学,2004,24(7):508-509
31. Robert A. Berg, Fred W. Chapman, Marc D. Berg, et al. Attenuated adult biphasic shocks compared with weight-based monophonic shocks in a swine
?model of prolonged pediatric vcntricular fibrillation[J]. Resuscitation 2004;61:189-197
32.Ballew KA, Philbrick JT. Causes of variation in reported in-hospital CPR survival: a critical review[J]. Resuscitation 1995;30:203-213
33.Eisenberg MS, Mengert TJ. Cardiac resuscitation[J]. N Engl J Med 2001;344: 1304-1313
34.Becker LB, Weisfeldlt ML, Weil MH, et al: The pulse Initiative. Scientific Priorities and strategic planning for resuscitation research and life saving therapies[J]. Circulation 2002;105: 2562-2570
35.Schoenenberger RA,Von Planta M,Von Planta I: Survival after failed out-of-hospital resuscitation[J]. Arch Intern Med 154:2433-2437, 1994
36. Kern KB, Postresuscitation myocardial dysfunction[J]. Cardiol Clin 2002;20:89-101
37.Cerchiari EL,Safa P,Klein E, et al.The cardiovascular post-resuscitation syndrom.Resuscitation, 1993, 25: 9-33
38.Kern KB,Hilwig RW,Rhee KH,et al.Myocardial dysfunction after resuscitation from cardiac arrest :An example of global myocardial stunning.J Am Coll Cardiol, 1996, 28:232-240
39.Bashir R,Padder FA.Myocardial stunning following respiratory arrest.Chest, 1995, 108: 1459-1460
40.Laurent I,Spaulding C,Monchi M,et al.Transient shock after successful resuscitation: Clinical evidence for post-cardiac arrest myocardial stunning. J Am Coll Cardiol 35(suppl A), 2000,399A
41.Redding JS, Pearson TW. Evaluation of drugs for cardiac resuscitation[J]. Anesthesiology, 1963;24: 203-7 [Abstract]
42.Midei MG, Sugiura S, Maughan WL, et al : Preservation of ventricular function by treatment of ventricular fibrillation with phenylephrine[J]. J Am Coll Cardiol 1990;16:489-494.
43. Ditchey RV, Lindenfeld J: Failure of epinephrine to improve the balance between myocardial oxygen supply and demand during close chest resuscitation in dog[J]. Circulation 1995;92: 3089-3093.
44. Tang W, Weil MH, Sun S, et al: Epinephrine increases the severity of post resuscitation myocardial dysfunction[J]. Circulation 1995;92: 3089-3093
45. Hilwig RW, Berg RA, Kern KB, et al: Endothelin-1 vasoconstriction during swine cardiopulmonary resuscitation improves coronary perfusion pressures but worsens postresuscitation outcome[J]. Circulation. 2000;101: 2097-2102
46. Xie J, Weil MH, Sun S, et al: High-energy defibrillation increases the Severity of postresuscitation mycardial dysfunction[J] . Circulation 1997;96: 683-688
47. Tang W, Weil MH, Sun S: low energy biphasic wave form defibrillation reduces the sererity of Postresuscition myocardial dysfunction[J]. Cri care Med. 2000;28: (suppl) N222-N224
48. Tang W, WeiL MH, Sun S et al : The effects of biphasic and conventional monophasic defibrillation on postresuscitation myocardial function[J]. J Am coll Cardiol 34: 815-822, 1999
49. Sun-S, Weil MH, Tang W, et al: Combined effects of buffer and adrenergic agents on postresuscitation myocardial function[J] . J Pharm Exper Therap 291: 773-777, 1999.
50. Ditchey RV, Rubio-Perez A, Slinker BK: β-adrenergic blocker reduces myocardial injury during experimental cardiopulmonary resuscitation[J]. J AM Coll Cardiol 1994;24: 804-812
51.孙宝莹 艾司洛尔的药理特点及临床应用[J].山东医药 2000,40 (7):61
52. Sudoh T, Kangawa K, Minamino N, et al. A natriureic peptide in porcine brain[J]. Nature. 1988, 322: 78.
53.黄彦生,魏经汉,魏太星等.脑钠素和N-心钠素 在无症状心力衰竭中的诊断价值[J].中国危重病急救医学,1998,10 (1):39-42.
54.巨年季,李卫鹏.BNP的临床应用价值[J].放射免疫学杂志,2004,17 (4):308～310。
55.王瑶,陶则伟,陆贤.B型钠尿肽的研究进展[J].心脏杂志,2003,15 (6):555—557。
56. Jawdat Abdulla, Lars Kober, et al: Methods of assessing the functional status of patient with left ventricular systolic dysfuction ininterventional studies: Can brain natriuretic peptide measurement be used as surrogate for the traditional methods?[J]. Cardiovascular Drugs and Therapy 2004;18: 219-214.
57. Tomas Jernberg, Stefan James, Bertil Lindah, et al: Natriuretic peptides in unstable coronary artery disease[J] . European Heart Journal 2004;25: 1486--1493.
58. XingXu, YuanZhou, QingMa, et al. Establishing a resuscitation model in rabbits with closed thoracic cardiopulmonary by-pass[J]. Resuscitation, 1994;27: 61-66
59. Fen Weiwang, Abdulfatah Osman, Javier Otero, et al: Distal myocardial protection during percutaneous coronary intervention with an intracoronary β -blocker[J]. Circulation, 2003;107: 2914-2919
60. McDonagh TA, Robb SD, Murdoch DR, et al. Biochemical detection of left ventricular systolic dysfunction[J]. Lancet 1998;351: 9 - 13.
61. Nagatsu M, Spinale FG, Koide M et al. Bradycardia and the role of β-blocker in the amelioration of left ventricular dysfunction[J]. Circulation 2000;101: 653-659
62. Philip M. Mottram, Brian A. Haluska, Thomas H. Marwick, et al. Response of B-Type natriuretic peptide to exercise in hypertensive patients with suspected diastolic heart failure: correlation with cardiac function, hemodynamics, and workload[J]. Am Heart J 2004;148- 365-370
63. Clyde W. Yancy. Practical considerations for BNP use[J]. Heart Failure Rcview 2003;8: 369-373
64. Roderick H. Tung, Christine Garcia, Alexander M. Morss, et al. Utility of B-Type natriuretic peptide for the evaluation of intensive care unit shock[J]. Crit Care Med 2004;32(8): 1643-1647
65. Julien Charpentier, Charles-Edouard, Yvonne Fulla, et al. Brain natriuretic peptide: A marker of myocardial dysfunction and prognosis during severe sepsis[J]. Crit Care Med 2004;32(3): 660-665
66.Lin PeiYi, Jiang HuiLing, Li YanPing, et al: The relationship between TNF-a, IL-6 and cardiac dysfunction in dog resuscitation from cardiac arrest[J]. Chin J Emerg Med 2005;14: 470-473
67.James T, Niemann, Daniel Garner, Roger J. Lewis, et al: Tumor necrosis factor-a is associated with early postresuscitation myocardial dysfunction[J]. Crit Care Med 2004;32:1753-1758
68.Christophe Adrie, Ivan Laurent, Mehran Monchi, et al. Postresuscitation disease after cardiac arrest: a sepsis-like syndrome[J]? Current Opinion in Critical Care, 2004,10: 208-212
2. The American Heart Association in collaboration with the international Liaison Committee on Resuscitation. Guidelines 2000 for Cardiopulmonary Resuscitation and Emergency Cardiovascular care[J]. Circulation. 2000;8(suppl): Ⅰ- 129-Ⅰ-135.
3.刘大为.危重病医学.北京:中国协和医科大学出版社,2000:5—50
4.邵孝鉷.急诊医学.北京:中国协和医科大学出版,2001:3—9
5.武建军、李利华、张颖丽等.大鼠心脏停搏期间心脏和肾脏α_1—肾上腺素能受体的变化[J] ,中国危重急救医学,1997:8 (9):456—462
6.王其新.现代临床急救进展.北京:人民军医出版社,2003:1—20
7. William C Shoemakrer, Stepen M , Ayres, Ake Grenvik, Peter R. Holbrook : Textbook of Critical Care(4th Edition), Harcourt Publishers International Company, 2001: 9—258
8. Haas T , Voelckel WG , Wenzel V , et al. Revisiting the cardiac versus thoracic pump mechanism during cardiopulmonary resuscitation [J]. Resuscitation, 2003 , 58 (1) : 113 - 116
9. Berg R, Hilwig RW, Ewy GA , et al. Precountershock cardiopulmonary resuscitation improves initial response to defibrillation from prolonged ventricular fibrillation : A randomized , controlled swine study[J] . Crit Care Med , 2004 , 32 (6) : 1352-1357
10. Frascone RJ, Bitz D, Lurie K. Combination of active compression decompression cardiopulmonary resuscitation and the inspiratory impedance threshold device: state of the art[J] . Curr Opin Crit Care, 2004, 10(3) : 193 - 201
11.高瑞,奚万山,陈伟宏等.大剂量肾上腺素对心肺复苏大鼠心肌超微结构的影响.中国危重病急救医学 1998;11 (10):648—652
12. Tommaso Pellis , Max Harry Weil , Wanchun Tang , et al. Evidence Favoring the Use of α_2-Selective Vasopressor Agent for Cardiopulmonary Resuscitation[J]. Circulation. 2003;11: 2716—2721
13. Lindner KH , Haak T , Keller A , et al. Release of endogenous vasopressors during and after cardiopulmonary resuscitation[J] . Heart, 1996, 75(2): 145-150
14. Krismer AC, Lindner KH, Wenzel V, et al. The effects of endogenous and exogenous vasopressin during experimental cardiopulmonary resuscitation. [J] Anesth Analg , 2001 , 92(6) : 1499 - 1504
15. Lindner KH, Prengel AW, Pfenninger EG, et al Vasopressin improves vital organ blood flow during closed - chest cardiopulmonary resuscitation in pigs[J] . Circulation , 1995 , 91 (1) : 215 - 221
16. Wenzel V, Lindner KH, Prengel AW, et al . Vasopressin improves vital organ blood flow after prolonged cardiac arrest with postcountershock pulseless electrical activity in pigs[J]. Crit Care Med , 1999 , 27(3) : 486 - 492
17. Strohmenger HU , Lindner KH , Keller A , et al . Effects of graded doses of vasopressin on median fibrillation frequency in a porcine model of cardiopulmonary resuscitation : results of a prospective, randomized, controlled trial[J] . Crit Care Med , 1996 , 24(8) : 1360 - 1365
18. Tusneyoshi I, Kanmura Y, Yoshimura N. Nitric oxide as a mediator of reduced arterical responsiveness in septic patients[J]. Crit Care Med, 1996, 24: 1083 - 1086
19.孟庆义,杜捷夫,沈洪等,氨茶碱在肾上腺素无效的心跳骤停患者中应用的初步研究[J].中国急救医学,2001,21(4):218—220
20. Dorrian P, Cass D, Schwart B, Cooper R, et al. Amiodarone as compared with lidocaine for shock-resistant fibrillation. N Engl J Med 2002;346(12): 884-890
21. Peter J, Kudenchuk, Gelaznikas R, et al. Amiodarone in out of hospital resuscitation of refractory sustained ventricuar tachyarrhythmias, N Engl J Med, 1999;341: 871-878
22. The hypothermia after cardiac arrest study group. Mild thcrapcutic hypothermia to improve the neurologic outcome after cardiac arrest[J] . N Engl J Med, 2002, 346(8) : 549 - 556
23. Jie Wei, Ling-LiLi, TaoLi. Protective effects of different sub-hypothermia methods on brain in rabbits after cardiopulmonary resuscitation[J]. 中国临床康复,2004;8:5442-5443
24. Bernard SA, Gray TW, Buist MD , et al. Treatment of comatose survivors of out-of-hospital cardiac arrest with induced hypothermia[J] . N Engl J Med , 2002 , 346 (8) : 557 - 5631
25. Bahringer W, Safar P , Wu X, et al. Survival without brain damage after clinical death of 60 - 120mins in dogs using suspended animation by profound hypothermia[J] . Crit Care Med , 2003 , 31 (5) : 1592 - 15931
26. Fischer M, Hossmann KA. No - reflow after cardiac arrest[J] . Intensive Care Med , 1995 , 21: 132 - 141.
27. Fischer M, Bottiger BW, Popov Cenic S , et al . Thrombolysis using plasminogen activator and heprin reduces cerebral no - reflow artery resuscitation from cardiac arrest : an experimental study in the cat[J]. Intensive Care Med , 1996 , 22: 1214 - 1223.
28. Gando B, Nanzaki S, Morimoto Y, et al . Tissue factor and tissue factor pathway inhibitor levels during and after cardiopulmonary resuscitation[J]. Thromb Res , 1999 , 96: 107 - 113.
29. Janata K, Holzer M, Kurkciyan I , et al. Major bleeding complication in cardiopulmonary resuscitation : the place of thrombolytic therapy in cardiac arrest due to massive pulmonary embolism[J] . Resuscitation , 2003 , 57(1) : 49 - 55.
30.康舟军.心肺复苏药物治疗新进展[J].中国急救医学,2004,24(7):508-509
31. Robert A. Berg, Fred W. Chapman, Marc D. Berg, et al. Attenuated adult biphasic shocks compared with weight-based monophonic shocks in a swine
?model of prolonged pediatric vcntricular fibrillation[J]. Resuscitation 2004;61:189-197
32.Ballew KA, Philbrick JT. Causes of variation in reported in-hospital CPR survival: a critical review[J]. Resuscitation 1995;30:203-213
33.Eisenberg MS, Mengert TJ. Cardiac resuscitation[J]. N Engl J Med 2001;344: 1304-1313
34.Becker LB, Weisfeldlt ML, Weil MH, et al: The pulse Initiative. Scientific Priorities and strategic planning for resuscitation research and life saving therapies[J]. Circulation 2002;105: 2562-2570
35.Schoenenberger RA,Von Planta M,Von Planta I: Survival after failed out-of-hospital resuscitation[J]. Arch Intern Med 154:2433-2437, 1994
36. Kern KB, Postresuscitation myocardial dysfunction[J]. Cardiol Clin 2002;20:89-101
37.Cerchiari EL,Safa P,Klein E, et al.The cardiovascular post-resuscitation syndrom.Resuscitation, 1993, 25: 9-33
38.Kern KB,Hilwig RW,Rhee KH,et al.Myocardial dysfunction after resuscitation from cardiac arrest :An example of global myocardial stunning.J Am Coll Cardiol, 1996, 28:232-240
39.Bashir R,Padder FA.Myocardial stunning following respiratory arrest.Chest, 1995, 108: 1459-1460
40.Laurent I,Spaulding C,Monchi M,et al.Transient shock after successful resuscitation: Clinical evidence for post-cardiac arrest myocardial stunning. J Am Coll Cardiol 35(suppl A), 2000,399A
41.Redding JS, Pearson TW. Evaluation of drugs for cardiac resuscitation[J]. Anesthesiology, 1963;24: 203-7 [Abstract]
42.Midei MG, Sugiura S, Maughan WL, et al : Preservation of ventricular function by treatment of ventricular fibrillation with phenylephrine[J]. J Am Coll Cardiol 1990;16:489-494.
43. Ditchey RV, Lindenfeld J: Failure of epinephrine to improve the balance between myocardial oxygen supply and demand during close chest resuscitation in dog[J]. Circulation 1995;92: 3089-3093.
44. Tang W, Weil MH, Sun S, et al: Epinephrine increases the severity of post resuscitation myocardial dysfunction[J]. Circulation 1995;92: 3089-3093
45. Hilwig RW, Berg RA, Kern KB, et al: Endothelin-1 vasoconstriction during swine cardiopulmonary resuscitation improves coronary perfusion pressures but worsens postresuscitation outcome[J]. Circulation. 2000;101: 2097-2102
46. Xie J, Weil MH, Sun S, et al: High-energy defibrillation increases the Severity of postresuscitation mycardial dysfunction[J] . Circulation 1997;96: 683-688
47. Tang W, Weil MH, Sun S: low energy biphasic wave form defibrillation reduces the sererity of Postresuscition myocardial dysfunction[J]. Cri care Med. 2000;28: (suppl) N222-N224
48. Tang W, WeiL MH, Sun S et al : The effects of biphasic and conventional monophasic defibrillation on postresuscitation myocardial function[J]. J Am coll Cardiol 34: 815-822, 1999
49. Sun-S, Weil MH, Tang W, et al: Combined effects of buffer and adrenergic agents on postresuscitation myocardial function[J] . J Pharm Exper Therap 291: 773-777, 1999.
50. Ditchey RV, Rubio-Perez A, Slinker BK: β-adrenergic blocker reduces myocardial injury during experimental cardiopulmonary resuscitation[J]. J AM Coll Cardiol 1994;24: 804-812
51.孙宝莹 艾司洛尔的药理特点及临床应用[J].山东医药 2000,40 (7):61
52. Sudoh T, Kangawa K, Minamino N, et al. A natriureic peptide in porcine brain[J]. Nature. 1988, 322: 78.
53.黄彦生,魏经汉,魏太星等.脑钠素和N-心钠素 在无症状心力衰竭中的诊断价值[J].中国危重病急救医学,1998,10 (1):39-42.
54.巨年季,李卫鹏.BNP的临床应用价值[J].放射免疫学杂志,2004,17 (4):308～310。
55.王瑶,陶则伟,陆贤.B型钠尿肽的研究进展[J].心脏杂志,2003,15 (6):555—557。
56. Jawdat Abdulla, Lars Kober, et al: Methods of assessing the functional status of patient with left ventricular systolic dysfuction ininterventional studies: Can brain natriuretic peptide measurement be used as surrogate for the traditional methods?[J]. Cardiovascular Drugs and Therapy 2004;18: 219-214.
57. Tomas Jernberg, Stefan James, Bertil Lindah, et al: Natriuretic peptides in unstable coronary artery disease[J] . European Heart Journal 2004;25: 1486--1493.
58. XingXu, YuanZhou, QingMa, et al. Establishing a resuscitation model in rabbits with closed thoracic cardiopulmonary by-pass[J]. Resuscitation, 1994;27: 61-66
59. Fen Weiwang, Abdulfatah Osman, Javier Otero, et al: Distal myocardial protection during percutaneous coronary intervention with an intracoronary β -blocker[J]. Circulation, 2003;107: 2914-2919
60. McDonagh TA, Robb SD, Murdoch DR, et al. Biochemical detection of left ventricular systolic dysfunction[J]. Lancet 1998;351: 9 - 13.
61. Nagatsu M, Spinale FG, Koide M et al. Bradycardia and the role of β-blocker in the amelioration of left ventricular dysfunction[J]. Circulation 2000;101: 653-659
62. Philip M. Mottram, Brian A. Haluska, Thomas H. Marwick, et al. Response of B-Type natriuretic peptide to exercise in hypertensive patients with suspected diastolic heart failure: correlation with cardiac function, hemodynamics, and workload[J]. Am Heart J 2004;148- 365-370
63. Clyde W. Yancy. Practical considerations for BNP use[J]. Heart Failure Rcview 2003;8: 369-373
64. Roderick H. Tung, Christine Garcia, Alexander M. Morss, et al. Utility of B-Type natriuretic peptide for the evaluation of intensive care unit shock[J]. Crit Care Med 2004;32(8): 1643-1647
65. Julien Charpentier, Charles-Edouard, Yvonne Fulla, et al. Brain natriuretic peptide: A marker of myocardial dysfunction and prognosis during severe sepsis[J]. Crit Care Med 2004;32(3): 660-665
66.Lin PeiYi, Jiang HuiLing, Li YanPing, et al: The relationship between TNF-a, IL-6 and cardiac dysfunction in dog resuscitation from cardiac arrest[J]. Chin J Emerg Med 2005;14: 470-473
67.James T, Niemann, Daniel Garner, Roger J. Lewis, et al: Tumor necrosis factor-a is associated with early postresuscitation myocardial dysfunction[J]. Crit Care Med 2004;32:1753-1758
68.Christophe Adrie, Ivan Laurent, Mehran Monchi, et al. Postresuscitation disease after cardiac arrest: a sepsis-like syndrome[J]? Current Opinion in Critical Care, 2004,10: 208-212