心肺复苏%自主循环恢复%亚低温%腹腔降温法%新西兰大白兔%神经元%海马%凋亡
心肺複囌%自主循環恢複%亞低溫%腹腔降溫法%新西蘭大白兔%神經元%海馬%凋亡
심폐복소%자주순배회복%아저온%복강강온법%신서란대백토%신경원%해마%조망
Cardiopulmonary resuscitation%Restore of spontaneous circulation%Hypothermia%peritoneal cooling%New Zealand rabbits%Neuron%Hippocampus%Apoptosis
目的 探讨心肺复苏(CPR)后腹腔降温法是否较其他降温法对新西兰兔海马CA1区神经元细胞损伤更具有保护作用.方法 48只新西兰成年大白兔,采用交流电致颤的方式建立CPR模型,依据降温方式的不同,随机(随机数字法)分为常温组(NT),腹腔内降温组(PC),体表降温组(SC)和头部局部降温组(LC)各12只.观察不同降温方法对自主循环恢复后( ROSC)鼓膜温度和血浆主要电解质的影响,ROSC后72 h取脑组织,计算海马CA1区有活力的神经元细胞数和凋亡神经元细胞数.各组数据依据正态检验结果用单因素方差分析( one-way ANOVA)或秩和检验(Mann-Whitney rank),多重比较用LSD-t检验,ROSC率的比较用用行×列连表x2检验,以P＜0.05为差异具有统计学意义.结果 ROSC后PC法能快速诱导亚低温,PC组达到目标温度的时间为(26±7)min,而SC组和LC组达到目标温度的时间分别为(60 ±9)min,(69±12) min；维持亚低温阶段,除NT组外,其余各组鼓膜温度均稳定的维持在33～35 ℃之间.ROSC后各组动物在各观察时间点上组间主要电解质、酸碱、水平衡和肾功能指标之间差异无统计学意义.ROSC后72 h海马CA1区有活力的神经元细胞数分别为NT组(37.07 ±6.43)个/40×、LC组(35.13 ±6.97)个/40×、PC组(55.76±10.13)个/40×和SC组(50.70 ±7.38)个/40× (PC vs.NT,P＜0.01,SC vs.NT,P＜0.01,PC vs.SC,P=0.043,PC vs.LC,P＜0.01,LC vs.NT,P=0.520).凋亡神经元细胞数分别为NT组(44.07 ±6.09)个/40×、PC组(29.88±4.81)个/40×、SC组(33.55 ±5.67)个/40×和LC组(42.27 ±5.20)个/40×(PC vs.NT,P＜0.01; SC vs.NT,P＜0.01; PC vs.LC,P＜0.01; SC vs.LC,P＜0.01,PC vs.SC,P=0.026),LCvs.NT,P=0.364).结论 ROSC后新型腹腔降温法能快速诱导亚低温和维持亚低温,对神经元的保护作用优于体表降温和头部局部降温法.
目的 探討心肺複囌(CPR)後腹腔降溫法是否較其他降溫法對新西蘭兔海馬CA1區神經元細胞損傷更具有保護作用.方法 48隻新西蘭成年大白兔,採用交流電緻顫的方式建立CPR模型,依據降溫方式的不同,隨機(隨機數字法)分為常溫組(NT),腹腔內降溫組(PC),體錶降溫組(SC)和頭部跼部降溫組(LC)各12隻.觀察不同降溫方法對自主循環恢複後( ROSC)鼓膜溫度和血漿主要電解質的影響,ROSC後72 h取腦組織,計算海馬CA1區有活力的神經元細胞數和凋亡神經元細胞數.各組數據依據正態檢驗結果用單因素方差分析( one-way ANOVA)或秩和檢驗(Mann-Whitney rank),多重比較用LSD-t檢驗,ROSC率的比較用用行×列連錶x2檢驗,以P＜0.05為差異具有統計學意義.結果 ROSC後PC法能快速誘導亞低溫,PC組達到目標溫度的時間為(26±7)min,而SC組和LC組達到目標溫度的時間分彆為(60 ±9)min,(69±12) min；維持亞低溫階段,除NT組外,其餘各組鼓膜溫度均穩定的維持在33～35 ℃之間.ROSC後各組動物在各觀察時間點上組間主要電解質、痠堿、水平衡和腎功能指標之間差異無統計學意義.ROSC後72 h海馬CA1區有活力的神經元細胞數分彆為NT組(37.07 ±6.43)箇/40×、LC組(35.13 ±6.97)箇/40×、PC組(55.76±10.13)箇/40×和SC組(50.70 ±7.38)箇/40× (PC vs.NT,P＜0.01,SC vs.NT,P＜0.01,PC vs.SC,P=0.043,PC vs.LC,P＜0.01,LC vs.NT,P=0.520).凋亡神經元細胞數分彆為NT組(44.07 ±6.09)箇/40×、PC組(29.88±4.81)箇/40×、SC組(33.55 ±5.67)箇/40×和LC組(42.27 ±5.20)箇/40×(PC vs.NT,P＜0.01; SC vs.NT,P＜0.01; PC vs.LC,P＜0.01; SC vs.LC,P＜0.01,PC vs.SC,P=0.026),LCvs.NT,P=0.364).結論 ROSC後新型腹腔降溫法能快速誘導亞低溫和維持亞低溫,對神經元的保護作用優于體錶降溫和頭部跼部降溫法.
목적 탐토심폐복소(CPR)후복강강온법시부교기타강온법대신서란토해마CA1구신경원세포손상경구유보호작용.방법 48지신서란성년대백토,채용교류전치전적방식건립CPR모형,의거강온방식적불동,수궤(수궤수자법)분위상온조(NT),복강내강온조(PC),체표강온조(SC)화두부국부강온조(LC)각12지.관찰불동강온방법대자주순배회복후( ROSC)고막온도화혈장주요전해질적영향,ROSC후72 h취뇌조직,계산해마CA1구유활력적신경원세포수화조망신경원세포수.각조수거의거정태검험결과용단인소방차분석( one-way ANOVA)혹질화검험(Mann-Whitney rank),다중비교용LSD-t검험,ROSC솔적비교용용행×렬련표x2검험,이P＜0.05위차이구유통계학의의.결과 ROSC후PC법능쾌속유도아저온,PC조체도목표온도적시간위(26±7)min,이SC조화LC조체도목표온도적시간분별위(60 ±9)min,(69±12) min；유지아저온계단,제NT조외,기여각조고막온도균은정적유지재33～35 ℃지간.ROSC후각조동물재각관찰시간점상조간주요전해질、산감、수평형화신공능지표지간차이무통계학의의.ROSC후72 h해마CA1구유활력적신경원세포수분별위NT조(37.07 ±6.43)개/40×、LC조(35.13 ±6.97)개/40×、PC조(55.76±10.13)개/40×화SC조(50.70 ±7.38)개/40× (PC vs.NT,P＜0.01,SC vs.NT,P＜0.01,PC vs.SC,P=0.043,PC vs.LC,P＜0.01,LC vs.NT,P=0.520).조망신경원세포수분별위NT조(44.07 ±6.09)개/40×、PC조(29.88±4.81)개/40×、SC조(33.55 ±5.67)개/40×화LC조(42.27 ±5.20)개/40×(PC vs.NT,P＜0.01; SC vs.NT,P＜0.01; PC vs.LC,P＜0.01; SC vs.LC,P＜0.01,PC vs.SC,P=0.026),LCvs.NT,P=0.364).결론 ROSC후신형복강강온법능쾌속유도아저온화유지아저온,대신경원적보호작용우우체표강온화두부국부강온법.
Objective To explore whether the peritoneal cooling was better than other cooling methods on protection neuron damage of the hippocampus CA1 after cardiopulmonary resuscitation (CPR) in New Zealand rabbits.Methods Forty eight adult New Zealand rabbits were induced ventricular fibrillation by AC current and were resuscitated after cardiac arrest for 5 minutes.The rabbits were randomly divided into four groups according to the way of cooling methods,nomothermia group ( NT),peritoneal cooling group (PC),surface cooling group (SC) and local cooling group (LC).The changes of tympanic membrane temperature were recorded in each animal and blood plasma concentrations of electrolyte were tested in each group at different time points after restore of spontaneous circulation (ROSC).Brain tissue were removed,the numbers of vigorous and apoptotic neurons in the hippocampus CA1 area were counted after ROSC at 72h.One-way ANOVA or Mann-Whitney rank was used to determine the statistical significance between two groups.LSD-t test for multiple comparisons,R × C test for ROSC comparisons,a two-tailed value of P ＜0.05 was considered statistically significant. Results Hypothermia was rapidly induced in PC after ROSC,and the time of arriving at target temperature was (26 ±7) min in PC,(60 ±9) min in SC,(69 ± 12) min in LC respectively; in the maintain hypothermia period,the tympanic membrane temperature was maintained at 33～ 35 ℃ in each group exception nomothermia group (NT).There were no differences with main electrolyte,acid-abase liquid balance and renal function between each group at each time point after ROSC.The numbers of vigorous neurons in hippocampus CA1 area were ( 37.07 ± 6.43 ) /40 × in NT group,(35.13 ± 6.97) /40 × in LC group,(55.76 ± 10.13 ) /40 × in PC group,and (50.70 ± 7.38 ) /40 × in SC group (PC:NT,P＜0.01,SC:NT,P＜0.01,PC:SC,P=0.043,PC:LC,P＜0.01,LC:NT,P=0.52).The numbers of apoptotic neurons were (44.07 ±6.09) /40 × in NT group,(29.88 ±4.81 ) /40× in PC group,( 33.55 ± 5.67 ) /40 × in SC group and ( 42.27 ± 5.20 ) /40 × in LC group respectively (PC:NT,P ＜0.01,SC:NT,P ＜0.01,PC:LC,P ＜0.01,SC:LC,P ＜0.01,PC:SC,P=0.026,LC:NT,P =0.364 ).Conclusions The new peritoneal cooling method could rapidly induce and maintain hypothermia,and it had better protections on neurons in hippocampus CA1 than surface cooling and local cooling method after ROSC in New Zealand rabbits.
