失血性心脏骤停兔模型的构建  

Establishment of hemorrhagic cardiac arrest model in rabbits

作　　者：张旻海 郑汝钢 菅洪健 梁国栋[1] 武钢[1] 

机构地区：[1]南方医科大学南方医院急诊科,广东广州510515

出　　处：《广东医学》2017年第8期1150-1154,共5页Guangdong Medical Journal

基　　金：广东省科技计划项目(编号:2013B010401014;2014A020212192)

摘　　要：目的构建失血性心脏骤停兔模型,以满足失血性心脏骤停基础研究的需要。方法选择27只新西兰兔分为假手术组(A组,无放血、无复苏)、未控制组(B组,放血但无复苏)、液体复苏组(C组,放血及复苏)。A组不作处理,B、C组经动静脉放血约放出50%的全身血量,达到心脏骤停后维持状态15 min,随后采用乳酸林格液和全血回输复苏。各时相点采动脉血测血气分析并统计输液量、失血量及6 h存活率。结果建模成功时B、C组血压显著降低,C组平均动脉压(MAP)下降至(14.5±5.3)mmHg。30 min MAP为(69.75±14.37)mmHg。在复苏5 min时pH值、动脉二氧化碳分压(PaCO_2)、红细胞压积(Hct)、血红蛋白(Hb)、实际碳酸氢盐(AB)、标准碳酸氢盐(SB)、实际碱剩余(ABE)、标准碱剩余(SBE)显著降低,K^+、乳酸水平显著升高(与0 min比较:P<0.01);在复苏25 min,仅K^+恢复至0 min水平,而AB、SB、SBE、ABE与乳酸均低于0 min水平(P<0.05)。Ca^(2+)在所测时间点皆与T0时间点比较差异无统计学意义(P>0.05)。结论通过动静脉联合放血构建的模型稳定性和可重复性高,适用于失血性心脏骤停的研究。Objective To establish a rabbit model of hemorrhagic cardiac arrest in rats. Methods Twenty - senven New Zealand rabbits were randomly divided into three groups, sham group （ Group A, with no bloodletting or resuscitation）, uncontrolled group （Group B, with bloodletting alone）, controlled groups （Group C, with bloodletting and resuscitation）. No treatment was given to subjects in Group A. An estimated 50% of total blood was withdrawn from the right jugular vein and the right femoral artery in Group B, and they were maintained at the state of cardiac arrest for 15 minutes. Resuscitation using lactated Ringer＇s solution （LR） and autotransfusion were performed in Groups C. Arterial blood sample was taken at each time point for blood gas analysis and coagulation test, and fluid requirements, blood loss and survival rate at 6h were recorded. Results After the cardiac arrest, the MAP decreased to 14. 5 ±5.3 mmHg. In the 30 rain resuscitation, spontaneous circulation had been regained, with the MAP of 69.75 ±14. 37 mmHg, the HR of 185.25 ±12. 89 times per rain. According to blood gas analysis, the pH value, PaCO2, Hct, Hb, actual bicarbonate, standard bicarbonate, actual base excess, and standard base excess were significantly reduced, and the K^＋ and lactic acid were significantly elevated in the 5 min of resuscitation （Compared with 0min, P 〈 0. 01 ）. The actual bicarbonate, standard bicarbonate, actual base excess and standard base excess were significantly lower at 25 rain of resuscitation than 0 min, except for K^＋. In the 25 rain of resucitation, the calcium value had no difference compared with TO all the time. Conclusion Through exsanguination from the right jugular vein and the right femoral artery, the hemorrhagic cardiac arrest model of rabbit was established to mimic the clinic situation and lay a foundation for further study of hemorrhagic cardiac arrest.

关 键 词：失血 心脏骤停 疾病模型 动物 

分 类 号：R541.78[医药卫生—心血管疾病]