不同吸氧时间对心脏骤停大鼠复苏后神经功能的影响  

Effect of different durations of post-resuscitation oxygen ventilation on neurological function in rats after cardiac arrest

作　　者：沈一鸣 王秋红 王建杰 李永勤[2] 张丹[1] SHEN Yiming;WANG Qiuhong;WANG Jianjie;LI Yongqin;ZHANG Dan(Department of Emergency Medicine,the First Affiliated Hospital of Chongqing Medical University,Chongqing,400016;Faculty of Biomedical Engineering and Imaging Medicine,Army Medical University(Third Military Medical University),Chongqing,400038,China)

机构地区：[1]重庆医科大学附属第一医院急诊医学科,重庆400016 [2]陆军军医大学(第三军医大学)生物医学工程与影像医学系,重庆400038

出　　处：《第三军医大学学报》2020年第11期1078-1085,共8页Journal of Third Military Medical University

基　　金：重庆市卫计委重点项目(2016ZDXM001);国家自然科学基金面上项目(81372102)。

摘　　要：目的研究常温下吸入纯氧不同时间,对窒息性心脏骤停大鼠复苏后神经功能预后的影响。方法将32只SD雄性大鼠经窒息诱导心脏骤停后6min进行心肺复苏。根据吸入纯氧时间的不同将大鼠按区组随机化分为4组(n=8):吸氧0min组(O2-0 min)、20min组(O2-20 min)、60min组(O2-60 min)和180min组(O2-180 min)。比较复苏后大鼠生理参数、脑电连续波形及各波段脑电功率能量。用酶联免疫吸附方法测量在基础状态及复苏后6 h血清cTnT和S100β蛋白浓度。比较神经功能缺损评分及96 h生存率,观察海马组织学改变。结果复苏后4组平均动脉压均较基础状态明显下降,左心室射血分数均呈先降后升的趋势。O2-180 min组平均动脉压、左心室射血分数显著高于O2-0 min组(P<0.05)。随着吸氧时间的延长,大鼠脑电恢复时间缩短,脑电图功率谱能量逐渐升高;O2-180 min组脑电恢复时间较O2-0 min组显著缩短,脑电图功率谱能量显著更高(P<0.05)。O2-180 min组在复苏后6 h脑组织及心肌损伤较O2-0 min组显著降低(S100β,P<0.01;cTnT,P<0.05)。O2-180 min组神经功能缺陷评分、生存率及海马组织损伤较O2-0 min组均明显改善。结论窒息诱导的大鼠心脏骤停模型中,常温下适当延长吸入纯氧时间,可以减轻脑组织损伤,改善神经功能预后,提高复苏后生存率。Objective To investigate the effect of pure oxygen ventilation under normothermia for different durations on the neurological outcome in a rat model of asphyxia cardiac arrest. Methods A total of 32 male SD rats were treated with cardiopulmonary resuscitation 6 min after cardiac arrest induced by asphyxia. After return of spontaneous circulation(ROSC), the rats were randomly divided into 4 groups according to the duration of ventilation of pure oxygen(8 in each group), that is, 0 min group(O2-0 min), 20 min group(O2-20 min), 60 min group(O2-60 min) and 180 min group(O2-180 min). Physiological parameters, continuous electroencephalography(EEG) waveforms, and EEG power of each band during post-resuscitation were recorded and compared among the groups. The serum contents of cardiac troponin T(cTnT) and S100 β protein were measured by enzyme-linked immunosorbent assay(ELISA) at the basic state and 6 h after resuscitation. The neurological deficit score(NDS), 96-hour survival rate and histological changes of hippocampus were compared in the groups. Results After resuscitation, the mean arterial pressure(MAP) was decreased significantly, and the left ventricular ejection fraction(LVEF) was decreased first and then increased in the 4 groups. The 2 indicators were significantly higher in the O2-180 min group than the O2-0 min group(P<0.05). With the increase of oxygen ventilation, shorter EEG recovery time and gradually stronger EEG power spectrum energy were observed in all the groups. The O2-180 min group had significantly shorter time and stronger energy than the O2-0 min group(P<0.05). At 6 h after resuscitation, cerebral and myocardial injuries were obviously milder in the O2-180 min group than the O2-0 min group(S100β, P<0.01;cTnT, P<0.05). NDS, survival rate and hippocampal injury were significantly improved in the O2-180 min group when compared with the O2-0 min group. Conclusion In this rat model of asphyxia cardiac arrest, prolonged pure oxygen inhalation under normothermia can alleviate cerebral injury, impr

关 键 词：心肺复苏 吸氧时间 脑损伤 缺血再灌注 

分 类 号：R459.6[医药卫生—治疗学] R541.78[医药卫生—临床医学]