经食道心脏起搏对大鼠自主循环恢复后血流动力学的影响  

THE EFFECT OF TRANSOESOPHAGEAL CARDIAC PACING ON THE HEMODYNAMICS AFTER RESTORATION OF SPONTANEOUS CIRCULATION

作　　者：陈蒙华[1] 刘唐威[1] 谢露[2] 宋凤卿[3] 何涛[1] 

机构地区：[1]广西医科大学第一附属医院心血管病研究所,南宁530021 [2]广西医科大学基础医学院生理学教研室 [3]广东省惠州市中心医院心内科

出　　处：《广西医科大学学报》2007年第3期358-361,共4页Journal of Guangxi Medical University

基　　金：广西教育厅资助课题;广西自然科学基金资助项目(No桂科自0135038和No0640081)

摘　　要：目的:观察经食道心脏起搏对自主循环恢复后血流动力学的影响。方法:选择SD大鼠40只,用窒息法复制心脏骤停动物模型,随机分成4组(n=10):盐水组(生理盐水1ml,iv)、低剂量肾上腺素组(0.04mg/kg,iv)、高剂量肾上腺素组(0.4mg/kg,iv)和起搏组(生理盐水1ml,iv+经食道心脏起搏)进行心肺复苏。自主循环恢复后比较各组大鼠的血流动力学变化。结果:盐水组,低、高剂量肾上腺素组和起搏组的自主循环恢复率分别为10%、90%、70%和80%。低、高剂量肾上腺素组大鼠的平均动脉压在复苏后5min达到峰值,然后进行性下降,而起搏组大鼠的平均动脉压在复苏后15min达到峰值并保持在平稳状态;低肾上腺素组和起搏组大鼠的心率在各个时间点均高于高剂量肾上腺素组大鼠且保持相对平稳状态,而高剂量肾上腺素组大鼠的心率在达到峰值后呈进行性下降。结论:低、高剂量肾上腺素和经食道心脏起搏均能提高窒息性心脏骤停大鼠的自主循环恢复率,但自主循环恢复后,经食道心脏起搏较肾上腺素能产生更为平稳的血流动力学效应,从而增加受试动物的生存概率和延长动物的生存时间。Objeetive： To identify how transoesophgeal cardiac pacing influences hemodynamics after restoration of spontaneous circulation （ROSC） and compares the results with those of different dose of epinephrine does in an asphyxia rat cardiac arrest model. Methods： Cardiac arrest was induced by means of asphyxi a in forty Sprague-Dawley rats of both sexes. The animals were randomly selected to a saline group （Sal- gro, treated with normal saline 1 ml, iv, n = 10）, low dose of epinephrine group （Lepi-gro, treated with epinephrine 0.04 mg/kg, iv, n ： 10）, high dose of epinephrine group （Hepi-gro, treated with epinephrine 0.4 mg/kg, iv, n ：10）, or a pacing group （Pac-gro, treated with normal saline 1 ml iv combined with transoesophageal cardiac pacing, n = 10） in a blinded fashion during resuscitation after 10 minutes of as- phyxial cardiac arrest. The changes of hemodynamics were compared among the groups after ROSC in resuscitated animals. Result： The rate of ROSC was 1 （10%）, 9（90%）, 7 （70%）, and 8 （80%） of 10 in Sal- gro, Lepi-gro, Hepi-gro and Pac-gro, respectively. Mean aortic pressure （MAP） in Pac-gro remained sta- ble unlike the Lepi-gro and Hepi-gro, which indicated a dropping tendency from peak value of MAP after ROSC. Heart rate （HR） in Pac-gro and Lepi-gro was higher than that of Hepi-gro and maintained a stable status; alternately, HR in Hepi-gro showed a decreasing from peak value of HR after ROSC. Conclusion： Both epinephrine and transoesophageal cardiac pacing increase the rate of ROSC in asphyxia rat cardiac arrest model. However, transoesphageal cardiac pacing produces more stable hemodynamics, and consequently increases more chances of survival and prolongs the survival time after ROSC for the victims of cardiac arrest.

关 键 词：心肺复苏 食道心脏起搏 血流动力学 大鼠 

分 类 号：R458.7[医药卫生—治疗学]