亚低温治疗对猪心脏骤停体外心肺复苏后免疫功能及神经功能的影响  

Effects of mild hypothermia treatment on the immune and neurological function in a swine model of extracorporeal cardiopulmonary resuscitation after cardiac arrest

作　　者：王晋祥[1] 续国武[1] 王太兰 王乐[3] 靳衡[1] 柴艳芬[1] WANG Jinxiang;XU Guowu;WANG Tailan;WANG Le;JIN Heng;CHAI Yanfen(Department of Emergency Medicine,Tianjin Medical University General Hospital,Tianjin 300052,China;Department of Infectious Diseases,First Hospital of Shanxi Medical University;Department of Neurosurgery,Tianjin Medical University General Hospital)

机构地区：[1]天津医科大学总医院急诊医学科,300052 [2]山西医科大学第一医院感染病科 [3]天津医科大学总医院神经外科

出　　处：《天津医药》2023年第10期1076-1079,共4页Tianjin Medical Journal

基　　金：天津市教委科研计划项目资助项目(2021KJ211)。

摘　　要：目的探讨亚低温治疗(MHT)对猪心脏骤停(CA)体外心肺复苏后免疫及神经功能指标水平的影响。方法采用随机数字表法将18只巴马香猪分为假手术(Sham)组、常温治疗(NT)组和MHT组,每组6只。NT组和MHT组经右心室诱颤建立CA模型,随后采取体外心肺复苏及体温管理,NT组目标体温37℃,MHT组目标体温32~36℃,Sham组仅进行造模常规置管,目标体温37℃。MHT组复温后对各组进行神经功能缺损(NDS)评分,随后处死动物并采集静脉血,检测脑损伤及免疫功能指标。结果与Sham相比,NT组与MHT组NDS评分升高,神经元特异性烯醇化酶(NSE)和S100B蛋白表达水平升高(均P<0.05);与NT组相比,MHT组NDS评分降低,NSE和S100B蛋白表达水平下降(均P<0.05);各组间IgM、IgA、IgG及T细胞亚群CD4、CD8、CD4/CD8水平差异无统计学意义。结论亚低温治疗可显著改善猪CA体外心肺复苏后神经功能,减轻脑损伤,且对免疫功能无显著影响。Objective To investigate the effect of mild hypothermia treatment(MHT)on levels of immune and neurological function indicators in a swine model of extracorporeal cardiopulmonary resuscitation after cardiac arrest(CA).Methods Eighteen Bama miniature pigs were randomly divided into the sham group,the normal temperature(NT)group and the mild hypothermia(MHT)group with 6 pigs in each group.CA model was established by right ventricular fibrillation in the NT group and the MHT group.Then cardiopulmonary resuscitationt and temperature management were followed.The target temperature of the NT group was 37℃,and the target temperature of the MHT group was 32-36℃.In the sham group,only conventional tube placement was performed,and the target temperature was 37℃.At 24 h after resuscitation,neurologic deficit score(NSD)was evaluated.Animals were then euthanized and venous blood sample was taken to detect brain injury and immune function indicators.Results Compared with the sham group,the NDS score increased in the NT group and the MHT group,and expression levels of neuron specific enolase(NSE)and S100B protein increased(P<0.05).Compared with the NT group,the NDS score,NSE and S100B protein expression levels were decreased in the MHT group(P<0.05).There were no significant differences in levels of IgM,IgA,IgG and T cell subsets CD4,CD8,CD4/CD8 between the groups.Conclusion Mild hypothermia treatment can significantly improve NDS,reduce brain injury after CA and has no significant effect on immune function.

关 键 词：低温 人工 猝死 心脏 心肺复苏术 磷酸丙酮酸水合酶 S100钙结合蛋白β亚基 

分 类 号：R459.7[医药卫生—急诊医学]