CAJ | 학술논문

目的对比窒息法与室颤法心搏骤停动物模型在心肺复苏过程中生理指标的变化特点及其在顶测自主循环恢复(restoration of spontaneous circulation,ROSC)率、24 h生存率中的作用.方法 60只SD大鼠随机(随机数字法)制作窒息法与室颤法心肺复苏大鼠动物(n=30)模型,持续监测呼气末二氧化碳(PETCO2)、主动脉压、左室压、肢体Ⅱ导联心电图,对比分析这两种模型中以上监测指标在复苏前、按压10 s、按压1 min、按压3 min、ROSC 1 h、ROSC 2 h的变化及其与ROSC率及24 h存活率的关系.结果 PETCO2、主动脉压、左室压及心电图在两种复苏动物模型各有其变化规律.室颤组ROSC大鼠在复苏前、按压1 min与按压3 min时的PETCO2高于Non-ROSC大鼠(P＜0.05),24 h存活大鼠在ROSC 1 h与ROSC 2 h的PETCO2高于24 h死亡大鼠(P＜0.05).而窒息组ROSC及24 h存活大鼠在各时间点的PETCO2与Non-ROSC及24 h死亡大鼠比较差异无统计学意义.室颤组在ROSC 1 h,ROSC2h的dp/dt40与-dp/dt40均低于窒息组(P＜0.05).结论窒息法与室颤法复苏动物模型各有特点,PETCO2在室颤法心搏骤停模型有助于预判ROSC及24 h生存率.研究者应根据自身的实验目的以及模拟的不同临床状况对所需的动物模型作出选择.
목적 대비질식법여실전법심박취정동물모형재심폐복소과정중생리지표적변화특점급기재정측자주순배회복(restoration of spontaneous circulation,ROSC)솔、24 h생존솔중적작용.방법 60지SD대서수궤(수궤수자법)제작질식법여실전법심폐복소대서동물(n=30)모형,지속감측호기말이양화탄(PETCO2)、주동맥압、좌실압、지체Ⅱ도련심전도,대비분석저량충모형중이상감측지표재복소전、안압10 s、안압1 min、안압3 min、ROSC 1 h、ROSC 2 h적변화급기여ROSC솔급24 h존활솔적관계.결과 PETCO2、주동맥압、좌실압급심전도재량충복소동물모형각유기변화규률.실전조ROSC대서재복소전、안압1 min여안압3 min시적PETCO2고우Non-ROSC대서(P＜0.05),24 h존활대서재ROSC 1 h여ROSC 2 h적PETCO2고우24 h사망대서(P＜0.05).이질식조ROSC급24 h존활대서재각시간점적PETCO2여Non-ROSC급24 h사망대서비교차이무통계학의의.실전조재ROSC 1 h,ROSC2h적dp/dt40여-dp/dt40균저우질식조(P＜0.05).결론 질식법여실전법복소동물모형각유특점,PETCO2재실전법심박취정모형유조우예판ROSC급24 h생존솔.연구자응근거자신적실험목적 이급모의적불동림상상황대소수적동물모형작출선택.
Objective To compare the changes of physiological parameters after cardiac arrest caused by asphyxia with that of cardiac arrest induced by ventricular fibrillation in rats and assess the values of the parameters on predicting ROSC and 24 h survival rate. Method Two groups of Sprague-Dwaley rats, which randomly (ramdom number) included 30 animals in each group, were investigated. Cardiac arrest were induced by asphyxia (AS group) or ventricular fibrillation(VF group). PETCO2, aortic pressure, left ventricular pressure and ECG of limb lead Ⅱ were recorded continuously, dP/dt4o was calculated with the windaq software. The parameters were compared between the two groups at baseline, precordial compression(PC) 10 s, PC 1 min, PC 3 min, ROSC 1 h and ROSC 2 h. The relations were explored between the parameters and ROSC/24 h survival rate. Results PETCO2,aortic pressure, left ventricular pressure and ECG have distinctive changes in the two groups. In group VF, PETCO2 of ROSC rats at BL, PC 1 min and PC 3 min were higher than those of Non-ROSC rats (P ＜ 0.05); PETCO2of 24 h survival rats at ROSC 1 h and ROSC 2 h were higher than those of 24 h death rats (P ＜ 0.05), which were not observed in the group AS. dP/dt40 and - dP/dt40 at ROSC 1 h and ROSC 2 h in group VF were higher than those in group AS (P ＜ 0.05). Conclusions Physiological parameters after cardiac arrest caused by asphyxia or that of cardiac arrest induced by ventricular fibrillation in rats have unique features respectively. PETCO2 in cardiac arrest caused by ventricular fibrillation may predict ROSC and 24 h survival rate. Researchers have to select the appropriate cardiac arrest model according their research purposes and clinical requirments.