Experimental Reseach On The Interventional Mechanism Of Shenmai Injection To The Rabbit Of PR-MODS

Cardiac arrest(CA):Heart function suddenly stopped, systemic blood circulationinstantly interrupt, lead to severe ischemia and hypoxia of the body tissues and organsin the, and the rapid emergence of serious irreversible damage and eventually lead todeath.It is one of the most serious accident and emergency in the ClinicalIntensive.With the continuous development of resuscitation theories and techniques,resumption of spontaneous circulation (ROSC) rate has increased over the previous,but the mortality of patients did not improve. Some data indicate that, out-of-hospitalcardiac arrest survival rate is about4%to33%, over80%of patients dead in the firstfew hours or days after ROSC. And that is closely related to multiple organdysfunction syndrome after resuscitation(PR-MODS).PR-MODS means in theCardiopulmonary resuscitation (CPR) and the recovery process, because stopped or inthe process of restoration of spontaneous circulation, the body has a strong stressresponse in patients. All tissues and organs have severe ischemia and reperfusioninjury. So that triggered the activation of a series of oxygen free radicals andinflammatory mediators released into the blood. Result in that major organs of thebody occur the inflammatory response syndrome, and trigger a special type ofmultiple organ dysfunction syndrome (MODS).It has become an independent factoraffecting survival rate after resuscitation, meanwhile one of the most commoncomplications after CA. PR-MODS is a kind of MODS which occur after cardiacarrest, as we also known as post resuscitation syndrome (PRS), ture out to be the mostcommon main reason lead to death in patients after successful resuscitation whoseexact pathogenesis is still not yet found has been considered a difficult problem in thefield of cardiopulmonary resuscitation at home and abroad. In recent years,it has notyet discovered the exact effect of drugs for the PR-with MODS in patients withmultiple organ protective intervention. With the increasing levels of modern scienceand technology, Chinese herbal medicine extraction technology has been rapidly developed. Recent years, traditional Chinese medicine preparation SMI has beenwidely used in clinical treatment of shock, coronary heart disease, myocardialinfarction, heart failure and systemic inflammatory syndrome(SIRS) of a variety ofcauses.But the studies on the SMI intervention PR-MODS has not been seen untilnow. In this study we discuss the Mechanism of SMI in the therapy of PR-MODS bymeans of use it to rabbits who suffer from CA and ROSC as adjuvant therapy.Objective:To compare and analyze the intervention effection of different doses of SMIinjection for rabbit cardiac arrest resuscitation of body organs damage. Explore SMIresuscitation multiple organ protection mechanism, provide a reliable theoreticalbasement for the SMI to determine the efficacy of prevention and treatment ofmultiple organ injury after resuscitation.Methods:Take63healthy adult clean level rabbits to establish cardiac arrest animal model.Monitoring of animal model building process in heart rate, blood pressure, ECGchanges, and all the rabbits are divided into small dose of the SMI group (group A)、large doses of the SMI group (group B) and non-SMI group namely the control group(C)according to whether using drugs for therapeutic intervention. Respectively, the3Group in the recovery before，after ROSC3h,6h,12h,24h,48h via the carotid arteryor the femoral artery blood4ml，4°C、3000r/min、10min，with supernatant store at-80°C until alternate. Detect CK-MB、ALT、Cr application of ELISA. Determinationof rabbit serum NF－κB、TNF－α、IL－1β、IL－6serum leves. Compared eachgroup dynamic changes of rabbits indicators. After ROSC12h、24h、48h withdifferent doses of the SMI group and non-SMI group, executed by some animals tocollect lung, heart, kidney, liver tissue, organs and tissues of the change in electronmicroscopy.Result:1、Three groups of cardiac arrest resuscitation rabbit model was no significantdifference in the recovery of CK-MB level of ALT and Cr have different degrees ofrecovery after each time point, but the SMI group of high-dose and low dose Shenmaigroup of CK-MB, ALT and Cr levels at6h,12h,24h and48h compared withthe control group decreased, especially in CK-MB were significantly lower；2、TNF-α、IL-1β、IL-6、NF–κB in varying degrees at different time points afterresuscitation increases, large doses of the SMI group were significantly lower in24hand48h, a significant difference compared with control group. TNF-α and NF-kBlevels in the recovery after12h SMI group than the control group were significantlylower;3、Electron microscopy observation of the three groups after ROSC,12h,24h,48h heart, liver, kidney, lung tissues are compared to a certain extent of damage, smalldoses of the SMI group and the control group no significant difference,in the SMIgroup of high-dose and control group organspathological changes have improvedslightly, but not significantly.Conclusion:1、Cardiac resuscitation rabbit models of organ damage are closely related withthe survival time.2、Cytokines（TNF－α、IL－1β、IL－6）、NF－κB levels of rabbitcardiac arrset model dynamic change in the PR-MODS and are proportional to thedegree of organ damage.3、After CPR, early application of SMI can inhibit or reducethe occurrence and development of PR-MODS, especially with a significantprotective effect on myocardial injury after CPR.