经右心室电刺激致颤建立家兔心脏骤停模型  

A sudden cardiac arrest rabbit model by electrically stimulated fibrillation through right ventricle

作　　者：肖盐[1] 林兆奋[1] 管军[1] 刁孟元[1] 张浙[1] 

机构地区：[1]解放军第二军医大学附属长征医院急救科,上海200003

出　　处：《中国急救医学》2014年第10期927-931,I0003,共6页Chinese Journal of Critical Care Medicine

基　　金：国家自然科学基金面上项目（30471464）

摘　　要：目的：建立一种简单、有效、稳定的家兔电刺激致颤心脏骤停（ CA）后脑复苏模型。方法选用20只新西兰雄性家兔，采用体表胸壁及心内膜下交流电诱发室颤的方法制作CA模型，CA 4 min后开始心肺复苏（CPR）。记录手术操作时间（TOP）、自主循环恢复时间（TROSC）、恢复率，除颤、肾上腺素次数，24 h、72 h存活率以及进行72 h大脑皮质凋亡细胞检测。另取10只兔为对照组，只进行致颤前手术操作。结果①20只家兔全部诱发CA成功，室颤发生率为100％。自主循环恢复率为80％；24 h、72 h存活率为50％、30％；除颤和肾上腺素次数为1．20±0.89、1．60±0．75；TOP和TROSC分别为（79±25）min、（268±33）s。②血浆神经元特异性烯醇化酶（NSE）水平显著升高，ROSC 72 h略有回降，但仍高于造模前（P＜0．05）。③与对照组比较，ROSC后72 h大脑皮质区出现了较多神经细胞的凋亡（P＜0．05）。④神经功能评分（NDS）在复苏后3 h时最低，以后渐趋好转。结论该模型操作简单、结果稳定、复苏成功率高，是一个较为理想的心肺脑复苏研究模型。Objective To establish a simple, effective and stable rabbit brain recovery method on electrically induced fibrillation cardiac arrest （CA）.Methods Twenty New Zealand male rabbits were used to set up a rabbit ventricular fibrillation induced CA model by introducing alternating current on the surface under the chest wall and endocardium and then start cardiopulmonary resuscitation （CPR） 4 minutes after CA .The operation time before CPR , restoration of spontaneous circulation （ ROSC ） time, spontaneous circulation response rates , 24 h, 72 h survival rate of the 20 rabbits, the defibrillation frequency , the administration frequency , TOP and TROSC and the apoptotic cells of cerebral cortex on ROSC 72 h have been recorded .For comparison, 10 other rabbits were taken for the surgical operation without fibrillation or CPR .Results ①Cardiac arrest was successfully induced in all 20 rabbits. Incidence of ventricular fibrillation was 100% after electrical stimulation .ROSC rate was 80% and 24 h, 72 h survival rate was 50% （10/20） and 30% （6/20）, respectively.The defibrillation frequency was 1.20 ±0.89.The frequency of intravenous injection of adrenaline was 1.60 ±0.75.TOP and TROSC were （ 79 ±25 ） minutes and （ 268 ±33 ） seconds , respectively .②The plasma enzyme specificity enolization of neurons （ NSE） levels increased significantly after building the model .It fell back slightly within 72 hours, but still higher than the level before the model was built （P〈0.05）.③Apoptosis of nerve cells appeared more in brain cortex after ROSC 72 h than that in the control group （P〈0.05）.④The lowest NDS was at 3 hours after ROSC , while the NDS increased gradually .The NDS of ROSC 72 h was 72.67 ±9.11 （n=6）.Conclusion The rabbit by chest and endocardium induced fibrillation CA model was easy to operate , had stable results and a high recovery rate .It is a relatively ideal cardiopulmonary cerebral resuscitation research model .

关 键 词：心脏骤停( CA) 心肺脑复苏 动物模型 兔 神经元特异性烯醇化酶( NSE) 神经功能评分( NDS) Cardiac ARREST ( CA) Specificity ENOLIZATION of neurons ( NSE) Neural DEFICIT scores ( NDS) 

分 类 号：R541.7[医药卫生—心血管疾病]