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1、英汉双解缩略词表缩略词英文全称中文全称TPTea polyphenols茶多酚OFRoxygen free radicals氧自由基IRIIschemia reperfusion injury缺血再灌注损伤SODsurfactant protein超氧化物歧化酶MDAMalondialdehyde丙二醛CA cardiac arrest心跳骤停CPRcardiopulmonary resuscitation心肺复苏ROSCRestoration of spontaneous circulation 自主循环茶多酚对心肺复苏大鼠生存时间和肾损伤的影响摘 要 目的：各种原因引起的心脏骤停（Card
2、iac arrest, CA）可导致全身器官严重缺血缺氧，及时有效的心肺复苏（Cardiopulmonary resuscitation, CPR）可能使部分患者恢复自主循环（Return of spontaneous circulation, ROSC），但与此同时也带来各器官组织的缺血再灌注损伤，严重影响复苏后生存时间和生存质量。如何降低复苏后的死亡率和病残率是目前医学界最为关注的热点之一。茶多酚（Tea polyphenols，TP）具有很强的抗氧化作用，对局部缺血再灌注损伤动物心、脑、肾具有保护作用。心脏骤停与心肺复苏的过程同样可导致全脑缺血再灌注损伤，茶多酚是否能够通过其抗氧化作用改
3、善CPR预后?本文通过建立窒息性心脏骤停大鼠模型，对ROSC后大鼠即刻应用TP，观察TP对血流动力学、生存时间及神经功能的影响，观察肾脏形态学改变，检测肾组织超氧化物歧化酶（Superoxide Dismutase, SOD）活力、丙二醛（Malondialdehyde，MDA）含量的变化，评价TP对CPR的影响，为探索抗氧化剂用于改善CPR后器官功能的治疗提供实验依据。方法：选用健康SD大鼠，体重320-440 g，水合氯醛麻醉（3ml/kg，腹腔注射），夹闭气管插管诱导窒息性心脏骤停，8min后给予胸外心脏按压及机械通气。按压1min时给予肾上腺素（0.04mg/kg），ROSC大鼠经静脉
4、即刻随机给予生理盐水（2ml/kg）或TP（10mg/kg），观察ROSC后1h内收缩压、舒张压及平均动脉压的变化，ROSC后大鼠的存活时间及复苏后24h、48h存活率，并进行神经功能评分。取存活到12h、24h、48h大鼠肾脏，常规切片，观察病理改变，肾组织匀浆检测SOD活力、MDA含量。结果：1.TP组与生理盐水组在ROSC后1h收缩压、舒张压和平均压无显著性差异，TP组大鼠的生存时间明显长于生理盐水组（37.311.2h vs 24.314.1h, P0.05），TP组ROSC后24h、48h生存率明显高于盐水组（P0. 01），且24、48 h神经功能评分显著高于生理盐水组（P0.05
5、）。2.形态学观察表明，TP能够减轻大鼠CPR后肾脏结构损伤。复苏后12h、24h、48h肾组织匀浆液SOD活力、MDA含量检测结果显示TP组和生理盐水组无显著性差异。结论：1.TP能改善窒息致心脏骤停大鼠心肺复苏预后，延长复苏后大鼠的生存时间，提高24h和48h生存率，同时改善神经功能。2.TP能减轻窒息致心脏骤停大鼠心肺复苏后肾脏结构损伤。关键词 茶多酚；窒息；心脏骤停；心肺复苏；肾保护THE EFFECT OF TEA POLYPHENOLS ON SURVIVAL TIME AND RENAL INJURY AFTER RESUSCITATION IN RATSABSTRACT Obj
6、ectives:Cardiac arrest (CA) caused by a variety of reasons results in severe anoxia and ischemia in bodys organs. Although timely and effective cardiopulmonary resuscitation (CPR) can bring return of spontaneous circulation (ROSC) in some patients, ischemic reperfusion injury occurs in organs at sam
7、e time, in turn to impact badly on suvival time and suvival quality after resuscitation. It is one of the most hotspot in medicine at present how to decrease mortality and disability rate after resuscitation. Tea polyphenols has strong antioxidant effect and can protect the heart, brain and kidney i
8、n local ischemia reperfusion. CPR and CA cause also ischemic reperfusion injury. If TP can improve CPR outcome via its antioxidant effect?this study evaluates the TP effect on CPR to provide experimental basis for antioxidant treatment on organ functional improvement after resuscitation. TP was used
9、 in an asphyxia rat model as soon as POSC. Hemodynamics, suvival time ane nerve function were monitored, renal morphologic alterations were observation, Superoxide Dismutase （SOD）and Malondialdehyde（MDA）of renal tissues were tested.Methods: SpragueDawley rats, weighing 200-400 g were anesthetized by
10、 Chloral Hydrate（3ml/kg，intraperitoneal injection）. Asphyxial cardiac arrest was induced by clamping the tracheal tubes. At the end of 8 min of asphyxiation, CPR was started with chest press and mechanical ventilation. Epinephrine (0.04mg/kg) was injected at 1 min of compression. The animals were tr
11、eated randomly with either saline (2ml/kg) or TP (10mg/kg) following ROSC. The changes of systolic pressure, diastolic pressure, mean arterial pressure were monitored after 1h of ROSC. Survival time, neurological deficit score (NDS) and the survival rate were recorded after 12, 24 and 48h of ROSC re
12、spectively. The renal conventional sections from 12h, 24h, 48h survival rats were doned to observe pathological changes. SOD, MDA of renal homogenate of these rats were assayed.Results:1.There was no significant difference in systolic pressure, diastolic pressure, mean arterial pressure within 1h of
13、 post-resuscitation in the TP group and the saline group. The survival time of rats in TP group was significantly longer than that of in saline group (37.311.2h vs 24.314.1h, P 0.05), 24h and 48h survival rates in TP group after ROSC and NDS score were also significantly higher than that of saline g
14、roup (P 0.01, P 0.05).2. The morphologic observation indicted that TP alleviated renal structural injury in post-resuscitation rats.There not were significant difference in SOD and MDA of renal homogenate of 24h, 48h suvival rats between TP group and saline groupConclusion:1.TP can improve CPR outco
15、me in asphyxial CA rats, presenting the enlongation of survival time, the increase survival rate of 24h and 48h with the improvement of nerve function.2. TP can alleviate renal structural injury in asphyxial CA rats.KEY WORDS Tea polyphenols; asphyxia; Cardiac arrest; Cardiopulmonary resuscitation;
16、renal protection前 言心肺复苏（Cardiopulmonary resuscitation, CPR）为呼吸终止及心跳停顿时，合并使用人工呼吸及心外按摩来进行急救的一种技术。各种原因引起的心脏骤停（Cardiac arrest, CA）可导致全身器官组织严重缺血缺氧，及时有效的心肺复苏（Cardiopulmonary resuscitation, CPR）可能使部分患者恢复自主循环（Return of spontaneous circulation, ROSC），但与此同时也带来各器官组织的缺血再灌注损伤，严重影响复苏后生存时间和生存质量，约四分之三ROSC者死于住院期间（死因包括心力衰竭、复发心脏骤停、缺血性脑病和感染）或有持久性神经系统后遗症，轻者智力障碍，重者成为植
