体外电除颤对心肌损伤标志物影响的实验研究  

Effects of Cardiac Damage Marker After External Defibrillating Current

作　　者：黄惠芳[1] 朱莹[1] 顾国浩[1] 

机构地区：[1]苏州大学附属第一医院检验科江苏省临床免疫学重点实验室,江苏苏州215006

出　　处：《苏州大学学报（医学版）》2009年第5期888-890,共3页Suzhou University Journal of Medical Science

基　　金：江苏省临床免疫学重点实验室基金资助项目(200319)

摘　　要：目的探讨电除颤对心肌的影响。方法对30头太湖猪进行电除颤,对除颤前及除颤后1、4、12、24、72h电解质(K+、Na+、Cl-)和心肌损伤标志物(AST、LDH、CK、CK-MB、CTnI)的含量进行比较。同时观察72h后处死的猪心肌的病理改变,从而判断心肌损伤程度。结果(1)电解质(K+、Na+、Cl-):除颤后各时间段与除颤前比较,差异无统计学意义(P>0.05)。(2)心肌标志物(AST、LDH、CK、CK-MB、CTn):与除颤前相比,心肌各标志物在除颤后12～72h的不同时间段有不同程度的升高。(3)病理结果:肉眼观察和显微镜检查发现,除颤后心肌有心内膜水肿、心肌出血、局部心肌断裂及退行性病变等病理变化。结论除颤对心肌有一定程度的损害,心肌损伤标志物检测有助于除颤后对心肌损伤的监测。Objective To investigate the effects of defibrillating current on myocardium. Methods Thirty Taihu Lake swines were chosen to be defibrillated. The conetent of dielectric （K＋,Na＋,Cl-） and cardiac muscle marker （AST,LDH,CK,CK-MB,CTn） at different time point were compared,that was performed before defibrillation,1 hour after that,and 4,12,24,72 hours after that respectively. The change of myocardium in swines,which had been killed 72 hours after defibrillation,were observed at the same time,so as to judge the damage level of myocardial. Results There was no significant difference between the contents of dielectric（K^＋,Na^＋,Cl^-）before defibrillation and after defibrillation（P〉 0.05）. The contents of cardiac damage marker （AST,LDH,CK,CK-MB,CTnI） after defibrillate were significantly higher than those before defibrillation （P〈0.05）. Through visual observation and microscope examination,defibrillation might cause endocardial edema,thrombosis,localized fragmentation of myocardium and retrograde change. Conclusion There are some damnification on cardia musle after it be defibrillated. It is suggested that cardiac damage marker conduce to judge the damage level of myocardial after defibrillation.

关 键 词：除颤 电解质 心肌标志物 猪 

分 类 号：R454.1[医药卫生—治疗学]