|
|
|
| Influence of urokinase on nerve cell apoptosis after cardiopulmonary resuscitation in rabbits |
| GUO Xiaodong1, ZHANG Wei2, GUO Jing3, SU Qingming4, YANG Guirong1,ZHANG Jie1,SUN Kun5,and WANG Lixiang5 |
1.The First Department of Critical Care Medicine, 3. Department of Medical Care, 4. Department of Pathology , 5. Department of Emergency,General Hospital of Chinese People's Armed Police Force, Beijing 100039,China;
2. Out-patient Department, Department of Information, General Staff Headquarters, Beijing 100840, China |
|
|
|
|
Abstract Objective To investigate the effect of urokinase on nerve cell apoptosis after cardiac arrest(CA) and cardiopulmonary resuscitation(CPR)in rabbits. Methods 20 rabbits were randomly divided into experimental group and control group, 10 rabbits in each group. Potassium chloride injection combined with asphyxia method was conducted to establish the CA models. CPR and basic life-support were performed in experimental group. Based on above treatments, intervention with urokinase (20 000 U/kg) was conducted in experimental group. Neural apoptosis was identified by TUNEL and caspase-3 was detected by immunohistochemistry in order to prove the effect of urokinase on nerve cell apoptosis in rabbits 24 hours after CPR. Results Tunel and caspase-3 positive cells counts of cerebral cortex and hippocampus in experimental group were significantly less than those in control group, respectively. The comparisons were as follows(Tunel positive cells in cerebral cortex 29.22±7.86: 37.20±7.04(t=-2.392,P=0.028), in hippocampus 18.80±7.58: 27.4±8.15(t=-2.442,P=0.025), Caspase-3 positive cells in cerebral cortex 22.1±9.93:33.1±12.64(t=-2.165,P=0.044),in hippocampus 31.3±15.23 vs 46.8±16.73(t=-2.167,P=0.044); so thrombolytic therapy with urokinase can relieve nerve cell apoptosis obviously. Comparison of spontaneous circulation restoration time(s) 307.9±96.4: 242.0±71.0(t=-1.741, P=0.099), spontaneous breathing restoration time(min) 20.6±12.5:19.3±10.0 (t=-0.256, P=0.801), mean arterial pressure MAP (mmHg) 65.5±6.2: 69.0±6.7 (t=1.217, P=0.239), there were no differences between the experimental group and control group. Conclusions Thrombolytic therapy with urokinase in CPR after CA can improve and lessen nervous lesion resulting from apoptosis in rabbits.
|
|
Received: 11 May 2015
|
|
|
|
|
|
| [3] |
Adrie C, Monchi M, Laurent I, et al. Coagulopathy after successful cardiopulmonary resuscitation following cardiac arrest: implication of the protein C anticoagulant pathway[J]. J Am Coll Cardiol,2005,46(1):21-28.
|
| [1] |
Eckstein M, Stratton S J, Chan L S. Cardiac arrest resuscitation evaluation in Los Angeles: CARE-LA[J]. Ann Emerg Med, 2005, 45(5): 504-509.
|
| [2] |
Nadkarni V M, Larkin G L, Peberdy M A, et al. First documented rhythm and clinical outcome from in-hospital cardiac arrest among children and adults[J]. JAMA, 2006, 295(1): 50-57.
|
| [4] |
Johansson J, Ridefelt P, Basu S, et al. Antithrombin reduction after experimental cardiopulmonary resuscitation[J]. Resuscitation, 2003, 59 (2): 235-242.
|
| [3] |
Adrie C, Monchi M, Laurent I, et al. Coagulopathy after successful cardiopulmonary resuscitation following cardiac arrest: implication of the protein C anticoagulant pathway[J]. J Am Coll Cardiol,2005,46(1):21-28.
|
| [5] |
Adrie C, Monchi M, Laurent I, et al. Coagulopathy after successful cardiopulmonary resuscitation following cardiac arrest: implication of the protein C anticoagulant pathway[J]. J Am Coll Cardiol, 2005, 46(1): 21-28.
|
| [6] |
Geppert A, Zorn G, Delle-Karth G, et al. Plasminogen activator inhibitor type 1 and outcome after successful cardiopulmonary resuscitation[J]. Crit Care Med, 2001, 29(9): 1670-1677.
|
| [4] |
Johansson J, Ridefelt P, Basu S, et al. Antithrombin reduction after experimental cardiopulmonary resuscitation[J]. Resuscitation, 2003, 59 (2): 235-242.
|
| [7] |
周景霞,齐丽敏,程瑞年. 心肺复苏患者凝血功能和血管性血友病因子动态变化及其与预后的关系[J]. 中国危重病急救医学,2009,21(12):734-737.
|
| [8] |
王胜奇,李春盛. 提高平均动脉压对猪心肺复苏后脑功能及超微结构的影响[J].中国危重病急救医学,2010,22(11):734-737.
|
| [9] |
郑得先.细胞凋亡的研究进展[J].中华病理学杂志,1996,25(1):50-53.
|
| [5] |
Adrie C, Monchi M, Laurent I, et al. Coagulopathy after successful cardiopulmonary resuscitation following cardiac arrest: implication of the protein C anticoagulant pathway[J]. J Am Coll Cardiol, 2005, 46(1): 21-28.
|
| [10] |
Li X, Fu Q L, Jing X J, et al. A meta-analysis of cardiopulmonary resuscitation with and without the administration of thrombolytic agents[J]. Resuscitation, 2006, 70(1): 31-36.
|
| [6] |
Geppert A, Zorn G, Delle-Karth G, et al. Plasminogen activator inhibitor type 1 and outcome after successful cardiopulmonary resuscitation[J]. Crit Care Med, 2001, 29(9): 1670-1677.
|
| [7] |
周景霞,齐丽敏,程瑞年. 心肺复苏患者凝血功能和血管性血友病因子动态变化及其与预后的关系[J]. 中国危重病急救医学,2009,21(12):734-737.
|
| [8] |
王胜奇,李春盛. 提高平均动脉压对猪心肺复苏后脑功能及超微结构的影响[J].中国危重病急救医学,2010,22(11):734-737.
|
| [9] |
郑得先.细胞凋亡的研究进展[J].中华病理学杂志,1996,25(1):50-53.
|
| [11] |
Mysiak A, Nowicki P, Kobusiak-Prokopowicz M. Thrombolysis during cardiopulmonary resuscitation[J]. Cardiol J, 2007, 14(1): 24-28.
|
| [10] |
Li X, Fu Q L, Jing X J, et al. A meta-analysis of cardiopulmonary resuscitation with and without the administration of thrombolytic agents[J]. Resuscitation, 2006, 70(1): 31-36.
|
| [12] |
Arntz H R, Wenzel V, Dissmann R, et al .Out-of-hospital thrombolysis during cardiopulmonary resuscitation in patients with high likelihood of ST-elevation myocardial infarction[J]. Resuscitation,2008,76(2): 180-184.
|
| [11] |
Mysiak A, Nowicki P, Kobusiak-Prokopowicz M. Thrombolysis during cardiopulmonary resuscitation[J]. Cardiol J, 2007, 14(1): 24-28.
|
| [13] |
楼正家,诸葛丽敏,郑文龙,等.川芎嗪对心肺复苏后脑缺血-再灌注损伤的保护作用[J].中国中西医结合急救杂志,2003,10(5):299-301.
|
| [14] |
许荣廷,宋慧玲,倪一虹,等.生脉注射液加护心通用于心肺脑复苏的临床研究[J].中国中西医结合急救杂志,2004,11(4):221-223.
|
| [12] |
Arntz H R, Wenzel V, Dissmann R, et al .Out-of-hospital thrombolysis during cardiopulmonary resuscitation in patients with high likelihood of ST-elevation myocardial infarction[J]. Resuscitation,2008,76(2): 180-184.
|
| [15] |
Crumrine R C, LaManna J C. Regional cerebral metabolites, blood flow, plasma volume, and mean transit time in total cerebral ischemia in the rat[J]. J Cereb Blood Flow Metab, 1991, 11(2): 272-282.
|
| [16] |
Chen M H, Liu T W, Xie L,et al.A comparison of transoesophageal cardiac pacing and epinephrine for cardiopulmonary resuscitation[J].Am J Emerg Med, 2006, 24(5): 545-552.
|
| [13] |
楼正家,诸葛丽敏,郑文龙,等.川芎嗪对心肺复苏后脑缺血-再灌注损伤的保护作用[J].中国中西医结合急救杂志,2003,10(5):299-301.
|
| [14] |
许荣廷,宋慧玲,倪一虹,等.生脉注射液加护心通用于心肺脑复苏的临床研究[J].中国中西医结合急救杂志,2004,11(4):221-223.
|
| [17] |
Liu W S,Huang Z Z, Wang X W,et al. Effects of microbubbles on transcranial Doppler ultrasound-assisted intracranial urokinase thrombolysis[J]. Thromb Res, 2012,130(3): 547-551.
|
| [15] |
Crumrine R C, LaManna J C. Regional cerebral metabolites, blood flow, plasma volume, and mean transit time in total cerebral ischemia in the rat[J]. J Cereb Blood Flow Metab, 1991, 11(2): 272-282.
|
| [18] |
Xanthos T, Lelovas P, Vlachos I, et al. Cardiopulmonary arrest and resuscitation in Landrace/Large White swine: a research model[J]. Lab Anim, 2007, 41(3): 353-362.
|
| [16] |
Chen M H, Liu T W, Xie L,et al.A comparison of transoesophageal cardiac pacing and epinephrine for cardiopulmonary resuscitation[J].Am J Emerg Med, 2006, 24(5): 545-552.
|
| [19] |
Wetsch W A, Sphr F, Teschendorf P, et al. Thrombolysis during cardiopulmonary resuscitation[J]. Dtsch Med Wochenschr, 2010, 135(40): 1983-1988.
|
| [17] |
Liu W S,Huang Z Z, Wang X W,et al. Effects of microbubbles on transcranial Doppler ultrasound-assisted intracranial urokinase thrombolysis[J]. Thromb Res, 2012,130(3): 547-551.
|
| [20] |
Adrie C, Laurent I, Monchi M, et al .Postresuscitation disease after cardiac arrest: a sepsis-like syndrome[J].Curr Opin Crit Care, 2004, 10(3): 208-212.
|
| [18] |
Xanthos T, Lelovas P, Vlachos I, et al. Cardiopulmonary arrest and resuscitation in Landrace/Large White swine: a research model[J]. Lab Anim, 2007, 41(3): 353-362.
|
| [19] |
Wetsch W A, Sphr F, Teschendorf P, et al. Thrombolysis during cardiopulmonary resuscitation[J]. Dtsch Med Wochenschr, 2010, 135(40): 1983-1988.
|
| [21] |
Janata K, Holzer M, Kurkciyan I, et al. Major bleeding complications in Cardiac arrest due to massive pulmonary embolism[J]. Resuscitation, 2003, 57(1): 49-55.
|
| [22] |
Laver S, Farrow C, Turner D, et al. Mode of death after admission to an intensive care unit following cardiac arrest[J]. Intensive Care Med, 2004, 30(11): 2126-2128.
|
| [20] |
Adrie C, Laurent I, Monchi M, et al .Postresuscitation disease after cardiac arrest: a sepsis-like syndrome[J].Curr Opin Crit Care, 2004, 10(3): 208-212.
|
| [21] |
Janata K, Holzer M, Kurkciyan I, et al. Major bleeding complications in Cardiac arrest due to massive pulmonary embolism[J]. Resuscitation, 2003, 57(1): 49-55.
|
| [22] |
Laver S, Farrow C, Turner D, et al. Mode of death after admission to an intensive care unit following cardiac arrest[J]. Intensive Care Med, 2004, 30(11): 2126-2128.
|
| [23] |
Snyder-Ramos S A, Bttiger B W. Molecular markers of brain damage--clinical and ethical implications with particular focus on cardiac arrest[J]. Restor Neurol Neurosci, 2003, 21(3-4): 123-139.
|
| [24] |
Lederer W, Lichtenberger C, Pechlaner C. Long-term survival and neurological outcome of patients who received recombinant tissue plasminogen activator during out-of-hospitald cardiac arrest[J]. Resuscitation, 2004, 61(2): 123-129.
|
| [23] |
Snyder-Ramos S A, Bttiger B W. Molecular markers of brain damage--clinical and ethical implications with particular focus on cardiac arrest[J]. Restor Neurol Neurosci, 2003, 21(3-4): 123-139.
|
| [24] |
Lederer W, Lichtenberger C, Pechlaner C. Long-term survival and neurological outcome of patients who received recombinant tissue plasminogen activator during out-of-hospitald cardiac arrest[J]. Resuscitation, 2004, 61(2): 123-129.
|
| [25] |
王胜奇,李春盛. 脑复苏中能量代谢与细胞凋亡[J]. 中国危重病急救医学,2010,22(11):702-704.
|
| [26] |
蔡宏斌,葛朝明,赵翀翀,等. 不同压力高压氧预处理与大鼠脑缺血灌注损伤缺血半暗带神经元细胞凋亡[J].中国康复医学杂志,2011,26(1):50-54.
|
| [25] |
王胜奇,李春盛. 脑复苏中能量代谢与细胞凋亡[J]. 中国危重病急救医学,2010,22(11):702-704.
|
| [26] |
蔡宏斌,葛朝明,赵翀翀,等. 不同压力高压氧预处理与大鼠脑缺血灌注损伤缺血半暗带神经元细胞凋亡[J].中国康复医学杂志,2011,26(1):50-54.
|
| [27] |
廖晓星,蔺际,李 欣,等. 抗凝溶栓药物对家兔复苏时血流动力学的影响[J].中国急救医学杂志,2008,28(8):724-727.
|
| [27] |
廖晓星,蔺际,李 欣,等. 抗凝溶栓药物对家兔复苏时血流动力学的影响[J].中国急救医学杂志,2008,28(8):724-727.
|
| [28] |
郭晓东,马立芝,高 进,等. 尿激酶对大鼠心肺复苏后脑神经细胞损伤及微血栓影响的实验研究[J].实用医学杂志,2006,7(22): 752-754.
|
| [28] |
郭晓东,马立芝,高 进,等. 尿激酶对大鼠心肺复苏后脑神经细胞损伤及微血栓影响的实验研究[J].实用医学杂志,2006,7(22): 752-754.
|
| [29] |
Matyal R, Mahmood F, Park K W. Tifacogin recombinant tissue factor pathway inhibitor[J]. Int Anesthesiol Clin, 2005, 43(2): 135-144.
|
| [29] |
Matyal R, Mahmood F, Park K W. Tifacogin recombinant tissue factor pathway inhibitor[J]. Int Anesthesiol Clin, 2005, 43(2): 135-144.
|
| [30] |
Aliyev F, Habeb M, Babalik E,et al . Thrombolysis with streptokinase during cardiopulmonary resuscitation: a single center experience and review of the literature[J]. J Thromb Thrombolysis, 2005, 20(3): 169-173.
|
| [30] |
Aliyev F, Habeb M, Babalik E,et al . Thrombolysis with streptokinase during cardiopulmonary resuscitation: a single center experience and review of the literature[J]. J Thromb Thrombolysis, 2005, 20(3): 169-173.
|
| [31] |
Aliyev F, Habeb M, Babalik E,et al . Thrombolysis with streptokinase during cardiopulmonary resuscitation: a single center experience and review of the literature[J]. J Thromb Thrombolysis, 2005, 20(3): 169-173.
|
| [31] |
Aliyev F, Habeb M, Babalik E,et al . Thrombolysis with streptokinase during cardiopulmonary resuscitation: a single center experience and review of the literature[J]. J Thromb Thrombolysis, 2005, 20(3): 169-173.
|
| [1] |
. [J]. Med. J. Chin. Peop. Armed Poli. Forc., 2019, 30(2): 147-149. |
|
|
|
|
2015, Vol. 26 
