Expressions And Correlation Of NF-κb On The Degree Of Multiple Organ Damage After CPR In Rabbit

Cardiac arrest is the most common and critical cardiovascular disease in clinical. With the development of cardiopulmonary resuscitaion(CPR) and monitoring techniques, the success rate of recovery has increased, however, the mortality remains high after CPR and only a small proportion of patients discharged alive. Some data show that in the course of CPR, the major organs are in a serious state of ischemia and hypoxia because of the stop of spontaneous circulation. At this moment, the body releases a series of inflammatory mediators and cytokines, these factors can lead to the activation of NF-κB, which can induce the expression of a variety of cytokines, chemokines, immune recognition receptors, then the mRNA of TNF-αand IL-1βand other inflammatory mediators can be transcribed, the inflammatory response amplified and network of cytokines formed. These can cause multi-organ ischemia-reperfusion(I/R) injury and lead to the occurrence of multiple organ dysfunction syndrome pro-resuscitation(PR-MODS). PR-MODS is the most common complication of CPR, also the most common cause of recovery failure, death and disability. The activation law of NF-κB in the circulatory system after CPR, to further clarify the relevant mechanisms of inflammation, understanding the association of NF-κB and MODS in the CPR progress all have important clinical significance to the prevention of the occurrence of early PR-MODS.Objective:By comparison and analysis of the level and variation of peripheral blood creatine kinase(CK-MB), troponin-I(cTnl), alanine aminotransferase(ALT), creatinine(CR) and NF-κB in different rabbit cardiac arrest resuscitation group and control group, while part organs and tissues are made for pathological analysis to investigate the relationship between NF-κB and the severity of multiple organ injury to provide a theoretical basis for the prevention and treatment of PR-MODS.Methods: Take 30 Chinese clean healthy adult rabbits to establish the model of cardiac arrest. Monitoring heart rate, blood pressure, electrocardiogram changes in the process of animal model establishing. Rabbits are divided into A group(survival <12h), B group(survival≥12h), C group(resuscitation failure group), and select 10 official holidays surgery group(D group) as the control group according to survival time after resuscitation. Take 4ml carotid or femoral artery blood at the moment of recovery, return of spontaneous circulation(ROSC) 0h, 1h, 3h, 6h, 12h, 24h to detect CK-MB,cTnI,ALT,CR and enzyme-linked immunosorbent assay(ELISA) is used to determine the activity of NF-κB to compare dynamics of the indicators in each group. Collect some of the heart, kidneys, liver, lung and small intestine of the sham group, death rabbit and rabbits that were sacrificed at the moment of ROSC 12h, 24h to observe changes in these organs and tissues in the electron microscope.Result:In the rabbit model of cardiac arrest, the level of blood CK-MB, ALT, CR was significantly higher at 3h after ROSC than before the recovery while cTnI was at 6h, A group has a higher degree than B group. The level of NF-κB in A, B group showed a trend of gradually increasing after ROSC and A group is more obvious than B. NF-κB in B group peaked in the ROSC 3h which is earlier than the peak of A group, followed by gradual decline, while the level is still higher than that before the recovery. CK-MB, cTnI, ALT, CR, NF-κB have no significant changes in group C. Varying degrees of damage happened in heart, liver, kindey, lung and small intestine in A, B group, and A group has a more serious injury than B, C group had no significant damage.Conclusion:1. Different degrees of multiple organ injury happened after cardiac arrest resuscitation in the rabbit model and the survival time associated with injury degree. 2. There is a dynamic change of NF-κB levels in the model of cardiac arrest and its expression related with the severity of multiple organ injury.