4 ℃盐水输注低温对猪心肺复苏后心肌组织超微结构的影响  

The influence of 4℃ cold saline on ultra structure of myocardium of swine after cardiopulnmna~ resuscitation

作　　者：卢一[1] 李春盛[2] 

机构地区：[1]北京安贞医院急诊科EICU,北京100029 [2]首都医科大学附属北京朝阳医院急诊科

出　　处：《中华急诊医学杂志》2010年第10期1027-1030,共4页Chinese Journal of Emergency Medicine

基　　金：国家自然科学基金资助项目（30972863）;首都医学发展科研基金资助项目（2005-1006）

摘　　要：目的 观察心肺复苏后输注4 ℃盐水降温对心肌组织超微结构的影响.方法 12只实验用北京长白猪,在朝阳医院动物实验室进行实验,直流电击诱导心室颤动,在室颤4 min后进行心肺复苏.复苏成功的猪10只,随机（随机数字法）分为2组：低温组（n=5）（4 ℃生理盐水静脉输注降温）与对照组（n=5）,监测血流动力学指标,并在电镜下观察心肺复苏后24 h心肌组织超微结构.统计方法采用两个样本的秩和检验.结果 复苏前后两组HR,MAP,CO差异无统计学意义（P＞0.05）;心肺复苏后24 h,对照组心肌肌丝断裂,线粒体空泡样变、嵴断裂;低温组心肌肌丝排列整齐,肌节清楚,线粒体结构清晰.结论 心肺复苏后静脉输注4 ℃盐水对心肌具有保护作用.Objective To observe the myocardial injury attributed to cardiopulmonary resuscitation, and to evaluate the impact of 4 ℃ saline perfusion on the ultra structure of myocardium. Method Twelve Pekimg white swine were induced to make models of ventricular fibrillation by direct current shock. Cardiopulmonary resuscitation was initiated 4 minutes after ventricular fibrillation established, and 10 swine survived from resuscitation. These swine were randomly（random number ） divided into hypothermia group （ n = 5） （ 4 ℃ saline infusion to lower the temperature） and control group （ n = 5）. Haemodynamics were monitored. And ultra structure of myocardium was observed under electron microscope 24 hours later. The Mann-Whitney test was used to compare the consecutive variables of 2 samples. Results The damage to the ultra structure of myocardium, myofilaments and mitochondria, was found in the control group, while that to a much lesser extent in the hypothermia group was observed. Conclusions After cardiopulmonary resuscitation, 4 ℃ saline infusion has a protective effect on myocardium.

关 键 词：心室颤动 心肺复苏 心肌 超微结构 低温 猪 

分 类 号：R459.7[医药卫生—急诊医学]