大鼠窒息法心搏骤停脑复苏模型的建立与评价  

Studying the establishment of rat model of asphyxial cardiac arrest and the efficacy of CPR

作　　者：姜骏[1] 李旷怡[1] 常瑞明[2] 常建星[2] 符岳[1] 黄子通[2] 

机构地区：[1]中山大学附属佛山医院,广东省佛山528000 [2]中山大学孙逸仙纪念医院中山大学心肺脑复苏研究所

出　　处：《中华急诊医学杂志》2014年第3期283-288,共6页Chinese Journal of Emergency Medicine

基　　金：国家自然科学基金（30801081）;教育部博士点专项基金（200805581179）;广东省医学科研基金（A2009179）

摘　　要：目的建立和评价大鼠窒息法心搏骤停脑复苏模型，探讨合适的窒息（AP）时间。方法实验在中山大学心肺脑复苏研究所完成。126只雄性SD大鼠随机（随机数字法）分为假手术组和实验组，通过静脉注射维库溴铵诱导窒息心搏骤停，实验组根据窒息时间不同分为AP4、AP6和AP8组，分别于心搏停止后4、6、8min给予机械胸外按压和同步通气复苏。记录复苏基本情况，复苏后1、3、7d，检测脑含水量、NDS评分、MRI影像学改变、脑组织病理损伤和神经元凋亡。统计分析采用单因素方差分析或X2检验，以P〈0．05为差异有统计学意义。结果复苏后第1天各实验组的NDS评分最低，复苏后3d脑含水量增加和MRI影像学损伤明显，7d时脑组织病理损伤和神经元凋亡达到高峰。AP4、AP6和AP8组复苏后24h存活率分别为85％、75％和45％，AP8组的ROSC率及24h存活率显著低于AP4和AP6组（P〈0．01）。随着窒息时间延长，各实验组大鼠复苏后脑水肿及影像学、组织学、神经功能损伤逐渐加重，其中AP8组各指标损伤最严重，AP6组损伤程度适中。结论成功构建了大鼠窒息法心搏骤停脑复苏模型，结合复苏存活率和脑组织损伤程度，建议将窒息6min作为该模型合适的缺血时间。Objective To study the establishment of rat model of asphyxia-cardiac arrest and efficacy of CPR in order to find the length of optimum time of asphyxia to cause injury. Methods One hundred and twenty-six male Sprague-Dawley rats were randomly （random number） divided into sham operation group and experimental groups. Cardiac arrest was induced by asphyxiation after intravenous injection of vecuronium bromide. The experimental groups were assigned into AP4 （four-minute asphyxia period）, AP6 and AP8 subgroups in accordance with different lengths of time of asphyxia subjected to. In these groups, CPR, including pre-cordial compression and synchronized mechanical ventilation, was initiated 4, 6 and 8 min after asphyxia-induced cardiac arrest, respectively. The successful ratio of resuscitation and hemodynamic variables were recorded. Brain water content, neural deficit scores （ NDS）, imaging changes on MR, pathological changes of brain tissue and neuronal apoptosis were evaluated at 1 d, 3 d and 7 days after ROSC. All the data were analyzed by single-factor analysis of variance or Chi-square test. P 〈 0. 05 was considered statistically significant. Result The lowest NDS occurred at 1 d after ROSC, brain water content and imaging changes on MR were most obvious at 3 d after ROSC, while pathological changes ofbrain tissue and neuronal apoptosis increased and reached the peak at 7d after ROSC. The survival rates after 24 hours of AP4, AP6 and AP8 groups were 85%, 75% and 45%, respectively. The rate of ROSC and survival rate of AP8 group were significantly lower than those of other groups （ P 〈 0. 01 ）. The longer time of asphyxia the severer pathological changes of brain tissue, brain edema, neural deficit, and magnetic resonance imaging changes in all experimental groups. As compared to other groups, the brain damage index of AP8 group was most serious, while that of AP6 group was moderate. Conclusions The rat model following asphyxia-induced cardiac arrest and cardiopulmonary resuscitation was esta

关 键 词：心搏骤停 心肺脑复苏 窒息 动物模型 脑含水量 神经功能缺损评分 病理损 伤 大鼠 

分 类 号：R459.7[医药卫生—急诊医学]