Experimental Study On The Effect Of Shenfu Injection On ATPase Of Myocardium In Rats After Cardiopulmonary Resuscitation

Objective: To investigate the changes of adenosine triphosphase (ATPase) activity, ion concentration of myocardial cell, red blood cell and the effect of Shenfu injection on them in rats after cardiopulmonary resuscitation(CPR); analysis the associativity of ATPase activity and ion concentration of myocardial cell and red blood cell.Methods: CA was induced by asphyxiation (succinylcholine) and ice-cold 0.5mol/L KCl in rats and resuscitation began five minutes later. In this experiment, fifty-six male SD rats were randomly divided into 7 groups,each group n=8: control group , common CPR groups (postresuscitation 0.5h, 2h, 4h), and Shenfu treatment groups (postresuscitation 0.5h, 2h, 4h). And using the chromametery, ATPase activity of myocardial cell and red blood cell were analyzed in each group. The ion concentrations(Na⁺,K⁺,Ca²⁺) were assessed by the inductively coupled plasma emission spectroscopy(ICP). The pathological changes of myocardium were observed under the optical and transmission electronic microscope (TEM).Result: Compared to the control group , there was a significant decreasing of Na⁺-K⁺-ATPase and Ca²⁺-ATPase activity of myocardial cell and red blood cell in common CPR groups (P<0.01). Na⁺-K⁺-ATPase activity reached the lowest values at 0.5 hour after restoration of spontaneous circulation(ROSC) and Ca -ATPase activity reached the lowest values at 2 hours after ROSC. The concentrations of Na and Ca increased significantly and K⁺ decreased evidently. The concentrations of Na⁺ and Ca²⁺ of myocardial cell reached the peak values and K⁺ reached the lowest values at 2 hours after ROSC.The concentration of Na⁺ of red blood cell reached the peak values at 0.5 hour after ROSC,but Ca²⁺ at 2 hours. The concentration of K⁺ reached the lowest values at 0.5 hour after ROSC. They all began to restore in some degrees after that. Under transmission electron microscope(TEM), crista mitochondriales was destructed, colloid grains increasd and vacuolar degeneration were observed in common CPR groups. Compared to the common CPR groups , Na⁺-K⁺-ATPase and Ca²⁺-ATPase activity increased significantly of myocardial cell and red blood cell in Shenfu treatment groups,but still under the normal level. Significant difference was found in Na⁺-K⁺-ATPase activity between the 0.5 hour groups (P<0.01) and Ca²⁺-ATPase activity between the 0.5 and 2 hours groups(P<0.01,0.05). The concentrations of Na⁺,Ca²⁺ and K⁺ restored evidently. Significant difference was found in the concentrations of Na⁺ (P<0.05,0.01) ,K⁺(P<0.01) and Ca²⁺(P<0.01)of myocardial cell between the 0.5 and 2 hours groups; it was also found in the concentrations of Na⁺ (P<0.01) ,K⁺(P<0.05),Ca²⁺ (P<0.01,0.05)of red blood cell between the same groups. Under TEM, the degree of injury of the ultramicrostructure was lightened obviously.There was a significant negative correlation between Na⁺-K⁺-ATPase activity and the Na⁺ concentrations of myocardial cell and red blood cell (r=-0.667,-0.559,P<0.01), and there was a significant positive correlation between Na⁺-K⁺-ATPase activity and the concentrations of K⁺(r=0.591,0.707,P<0.01).The relation between Ca²⁺-ATPase activity and the concentrations of Ca²⁺(r=-0.542,-0.754,P<0.01)was the same as Na⁺-K⁺-ATPase activity and the concentration of Na⁺.These indexes of myocardial cell are in positive correlation with those of red blood cell (r=0.764,0.658, 0.649, 0.644, 0.553,P<0.01).Conclusion: Na⁺-K⁺-ATPase and Ca²⁺-ATPase activity of myocardial cell and red blood cell decreased after CPR. The concentrations of Na⁺and Ca²⁺ increased ,but K⁺ decreased. They seem to be responsible for the injury of myocardial cell. Shenfu injection increase ATPase activity and improve ion disbalance of myocardial cell after CPR by anti-ischemia, anti-hypoxia, scavenging oxygen free radicals, anti-lipid peroxidation, reducing intracellular Ca²⁺overloading, improving microcirculation and oxygenation. Shenfu injection also has the function of protecting the ultramicrostructure. So it plays an important role in the protection of myocardial cell after CPR. ATPase activity and ion concentration of myocardial cell are in positive correlation with those of red blood cell, so these indexes of red blood cell can approximately reflect those of myocardial cell,and indirectly reflect the degree of injury of myocardial cell.