增强型体外反搏增加心脏骤停犬颈总动脉血流量  

Enhanced external counterpulsation improves common carotid artery blood flow in sudden cardiac arrest dogs

作　　者：刘荣[1,2] 廖晓星[1] 李欣[1] 胡春林[1] 魏红艳[1] 冯铭哲[3] 伍贵富[3] 戴刚[3] 

机构地区：[1]中山大学附属第一医院急诊科,广东广州510080 [2]广州医学院第一附属医院急诊科,广东广州510120 [3]中山大学附属第一医院卫生部辅助循环重点实验室,广东广州510080

出　　处：《中国病理生理杂志》2012年第6期1124-1127,1131,共5页Chinese Journal of Pathophysiology

基　　金：广东省科技攻关项目(No.2011B080701006);广东高校产学研结合示范基地科技成果产业化重大项目(No.cg-zhzd0702);广东省科技计划项目(No.2008B030301332)

摘　　要：目的:探讨增强型体外反搏(EECP)干预对心脏骤停(SCA)犬颅内压(ICP)、脑灌注压(CPP)和右颈总动脉平均流量(MQ)的影响。方法:12只犬制成SCA模型,经心肺复苏至自主循环恢复(ROSC)后随机分成对照组(4只)和EECP组(6只),2只建模未成功。EECP组分别行2次1 h EECP干预,观察致颤前后、ROSC后(每1 h)ICP、CPP和MQ的变化,ROSC 6 h后停止监测。结果:平均动脉压(MBP)、收缩期血压峰值(MSP)、ICP、平均脑灌注压(MCPP)和收缩期脑灌注压峰值(SCPP)组间比较差异无统计学意义(P>0.05);EECP时舒张期血压峰值(MDP)和舒张期脑灌注压峰值(DCPP)明显高于对照组(P<0.05)。EECP组颈总动脉血流阻力在EECP时明显低于对照组(P<0.05)。EECP时MQ明显高于对照组(P<0.05)。结论:EECP并不影响SCA-ROSC模型MBP、MSP、ICP、MCPP和SCPP而是通过增加MDP、DCPP和降低血流阻力等机制来增加颈总动脉的平均血流量。AIM： To investigate the effects of enhanced external counterpulsation （EECP） on intracranial pressure （ICP）, cerebral perfusion pressure （CPP）, common carotid artery blood flow following sudden cardiac arrest （SCA） and successful return of spontaneous circulation （ROSC） by cardiopulmonary resuscitation （CPR） in dogs. METHODS： Dog SCA model was induced with alternating current, then 10 dogs were randomly divided into EECP group （n=6） and control group （n=4） after successful ROSC. The arterial blood pressure （BP）, quantity of right common carotid artery blood flow （Q） and intracranial pressure （ICP） were measured. Cerebral perfusion pressure （CCP） equaled to BP minus ICP. Resistance of common carotid artery equaled to mean BP/mean Q. RESULTS： The animal model of SCA-ROSC in 10 dogs were successfully established. No significant difference of mean blood pressure （MBP）, maximum systolic pressure （MSP）, mean ICP, systolic ICP, diastolic ICP, mean CPP and maximum systolic CPP at all time points between the 2 groups was observed. Compared with control group, the maximum diastolic pressure （MDP） and maximum diastolic CPP was significantly elevated, the resistance of common carotid artery was significantly decreased, and right common carotid artery blood flow was significantly increased in EECP group. CONCLUSION： EECP does not affect MBP, MSP, ICP, mean CPP and systolic CPP,but improves common carotid artery blood flow possibly by increasing diastolic BP, diastolic CPP and reducing the resistance of common carotid artery or other mechanisms.

关 键 词：增强型体外反搏 心脏骤停 颅内压 脑灌注压 血流量 狗 

分 类 号：R541.7[医药卫生—心血管疾病]