短效β-上腺抗剂埃斯莫洛尔在再注射时给予,改善了长时间心室动后的存活率
Cheryl R Killingsworth1, Chih-Chang Wei, Louis J Dell'Italia
1Cardiac Rhythm Management Laboratory, Division of Cardiovascular Diseases, Department of Medicine, University of Alabama at Birmingham, AL 35294-0019, USA. crk@crml.uab.edu
Circulation
|May 5, 2004
概括
在长时间的心室动 (VF) 和除后,高水平的甲基荷胺激增. 在再注射时使用β阻塞剂埃斯莫洛尔 (esmolol) 改善了心脏骤停模型中的存活率.
科学领域:
- 心脏病学 心脏病学
- 紧急医疗 紧急医疗
- 药理学 药理学是指药理学的学科.
背景情况:
- 高度的甲基荷兰胺对心脏细胞有毒.
- 静脉动 (VF),除和再注血可以导致catecholamines的激增.
研究的目的:
- 为了研究心肌间歇性catecholamine在长时间VF,除和再注射后的水平.
- 为了确定埃斯莫洛尔是否能防止这种甲醇胺激增,并改善生存率.
主要方法:
- 用猪的放射性酶定量测试在心肌间歇液和血中的量化甲基胺.
- 诱导8分钟的VF,然后进行除和再输血.
- 在一个单独的组中,在再注射时服用埃斯莫洛尔或盐水.
主要成果:
- 心肌间歇性上腺素和上腺素水平在VF期间显著增加,在除后达到峰值.
- 埃斯莫洛尔的使用改善了自发循环的恢复.
- 埃斯莫洛尔治疗导致显著更高的4小时生存率 (7/8) 与盐水相比 (3/8).
结论:
- 在长时间的VF,除和再注血后,肌肉心脏中catecholamines的大量,短暂的升高发生.
- 早期服用短效β-对抗剂,如埃斯莫洛尔,可以提高心脏骤停后的存活率.
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