CAJ | 학술논문

在13只犬的低能量心脏除颤实验中，应用病理检查、除颤心电图记录以及除颤前后肌酸磷酸激酶及其同工酶(CPK和CPK-MB)测定三种方法探测心肌损伤。肉眼观察和显微镜检查见到5只犬（除颤7～21次，能量10～40 J）电极处心脏轻度充血,2只犬（除颤9～20次，能量20～50 J）心肌苍白、心内膜附有血栓,6只犬（除颤7～29次，能量10～60 J）心内膜水肿、血栓形成、局部心肌断裂和退行性变、心肌间质出血等病理变化。记录到4只犬（除颤8～24次，能量20～50 J）除颤放电后ST段压低或ST段抬高心电图波形。测得2只犬（除颤10～19次，能量5～40J）除颤后CPK和CPK-MB有轻度升高(1只CPK由104升至110 IU,另1只CPK-MB由47.1升至60.9 IU)。本实验提示：低能量心脏除颤可导致心肌损伤；损伤可能由热和电等因素造成；损伤程度与除颤能量和除颤脉冲间隔时间等因素有关；损伤范围为局灶性且可能愈合。
재13지견적저능량심장제전실험중，응용병리검사、제전심전도기록이급제전전후기산린산격매급기동공매(CPK화CPK-MB)측정삼충방법탐측심기손상。육안관찰화현미경검사견도5지견（제전7～21차，능량10～40 J）전겁처심장경도충혈,2지견（제전9～20차，능량20～50 J）심기창백、심내막부유혈전,6지견（제전7～29차，능량10～60 J）심내막수종、혈전형성、국부심기단렬화퇴행성변、심기간질출혈등병리변화。기록도4지견（제전8～24차，능량20～50 J）제전방전후ST단압저혹ST단태고심전도파형。측득2지견（제전10～19차，능량5～40J）제전후CPK화CPK-MB유경도승고(1지CPK유104승지110 IU,령1지CPK-MB유47.1승지60.9 IU)。본실험제시：저능량심장제전가도치심기손상；손상가능유열화전등인소조성；손상정도여제전능량화제전맥충간격시간등인소유관；손상범위위국조성차가능유합。
During low energy defibrillation experiments in 13 dogs,three methods for the detection of myocardial injury were used:pathologic examination,defibrillation electrocardiogram recording,and creatine phosphokinase (CPK) and CPK-MB determination before and after defibrillation.In visual observation and microscopic examination,5 dogs (7～21 shocks,10～40 J) showed slight hyperemia in the area around electrodes,2 dogs (9～20 shocks,20～50 J) showed pale myocardium,and endocardium with thrombi.Also,pathologic changes including endocardial edema,thrombosis,localized fragmentation of myocardium and retrograde changes,and myocardial interstitial hemorrhage were found in 6 dogs (7～29 shocks,10～60 J).ST-T segment changes in electrocardiographic patterns were recorded after defibrillation charges in 4 dogs(8～24 shocks,20～50 J).CPK and CPK-MB showed slight elevation in 2 dogs (10～19 shocks ,5～40 J) after receiving defibrillation shocks,with CPK elevated from 104 to 110 IU in one,and CPK-MB from 47.1 to 60.9 IU in the other.This study suggests the following:low energy defibrillation may cause myocardial injury,with heat and electricity as possible causative factors;the degree of injury is related to the energy used for defibrillation and the time intervals between shocks;the injury is localized,and may heal.