窒息法与室颤法心肺复苏动物模型的比较研究  

Comparison of cardiac arrest induced by ventricular fibrillation or induced by asphyxia in rats

作　　者：朱军[1] 方向韶[1] 符岳[1] 姜骏[1] 李恒[1] 梁嘉康[1] 黄子通[1] 

机构地区：[1]中山大学附属第二医院急诊科/中山大学心肺脑复苏研究所,广州510120

出　　处：《中华急诊医学杂志》2011年第1期14-19,共6页Chinese Journal of Emergency Medicine

基　　金：国家自然科学基金资助项目（30700303）;广东省自然科学基金资助项目（8151008901000100）

摘　　要：目的 对比窒息法与室颤法心搏骤停动物模型在心肺复苏过程中生理指标的变化特点及其在顶测自主循环恢复（restoration of spontaneous circulation,ROSC）率、24 h生存率中的作用.方法 60只SD大鼠随机（随机数字法）制作窒息法与室颤法心肺复苏大鼠动物（n=30）模型,持续监测呼气末二氧化碳（PETCO2）、主动脉压、左室压、肢体Ⅱ导联心电图,对比分析这两种模型中以上监测指标在复苏前、按压10 s、按压1 min、按压3 min、ROSC 1 h、ROSC 2 h的变化及其与ROSC率及24 h存活率的关系.结果 PETCO2、主动脉压、左室压及心电图在两种复苏动物模型各有其变化规律.室颤组ROSC大鼠在复苏前、按压1 min与按压3 min时的PETCO2高于Non-ROSC大鼠（P＜0.05）,24 h存活大鼠在ROSC 1 h与ROSC 2 h的PETCO2高于24 h死亡大鼠（P＜0.05）.而窒息组ROSC及24 h存活大鼠在各时间点的PETCO2与Non-ROSC及24 h死亡大鼠比较差异无统计学意义.室颤组在ROSC 1 h,ROSC2h的dp/dt40与-dp/dt40均低于窒息组（P＜0.05）.结论 窒息法与室颤法复苏动物模型各有特点,PETCO2在室颤法心搏骤停模型有助于预判ROSC及24 h生存率.研究者应根据自身的实验目的 以及模拟的不同临床状况对所需的动物模型作出选择.Objective To compare the changes of physiological parameters after cardiac arrest caused by asphyxia with that of cardiac arrest induced by ventricular fibrillation in rats and assess the values of the parameters on predicting ROSC and 24 h survival rate. Method Two groups of Sprague-Dwaley rats, which randomly （ramdom number） included 30 animals in each group, were investigated. Cardiac arrest were induced by asphyxia （AS group） or ventricular fibrillation（VF group）. PETCO2, aortic pressure, left ventricular pressure and ECG of limb lead Ⅱ were recorded continuously, dP/dt4o was calculated with the windaq software. The parameters were compared between the two groups at baseline, precordial compression（PC） 10 s, PC 1 min, PC 3 min, ROSC 1 h and ROSC 2 h. The relations were explored between the parameters and ROSC/24 h survival rate. Results PETCO2,aortic pressure, left ventricular pressure and ECG have distinctive changes in the two groups. In group VF, PETCO2 of ROSC rats at BL, PC 1 min and PC 3 min were higher than those of Non-ROSC rats （P 〈 0.05）; PETCO2of 24 h survival rats at ROSC 1 h and ROSC 2 h were higher than those of 24 h death rats （P 〈 0.05）, which were not observed in the group AS. dP/dt40 and - dP/dt40 at ROSC 1 h and ROSC 2 h in group VF were higher than those in group AS （P 〈 0.05）. Conclusions Physiological parameters after cardiac arrest caused by asphyxia or that of cardiac arrest induced by ventricular fibrillation in rats have unique features respectively. PETCO2 in cardiac arrest caused by ventricular fibrillation may predict ROSC and 24 h survival rate. Researchers have to select the appropriate cardiac arrest model according their research purposes and clinical requirments.

关 键 词：心搏骤停 心肺复苏 窒息 室颤 自主循环恢复 生存率 大鼠 

分 类 号：R459.7[医药卫生—急诊医学]