CAJ | 학술논문

目的：建立一种简单、有效、稳定的家兔电刺激致颤心脏骤停（ CA）后脑复苏模型。方法选用20只新西兰雄性家兔，采用体表胸壁及心内膜下交流电诱发室颤的方法制作CA模型，CA 4 min后开始心肺复苏（CPR）。记录手术操作时间（TOP）、自主循环恢复时间（TROSC）、恢复率，除颤、肾上腺素次数，24 h、72 h存活率以及进行72 h大脑皮质凋亡细胞检测。另取10只兔为对照组，只进行致颤前手术操作。结果①20只家兔全部诱发CA成功，室颤发生率为100％。自主循环恢复率为80％；24 h、72 h存活率为50％、30％；除颤和肾上腺素次数为1．20±0.89、1．60±0．75；TOP和TROSC分别为（79±25）min、（268±33）s。②血浆神经元特异性烯醇化酶（NSE）水平显著升高，ROSC 72 h略有回降，但仍高于造模前（P＜0．05）。③与对照组比较，ROSC后72 h大脑皮质区出现了较多神经细胞的凋亡（P＜0．05）。④神经功能评分（NDS）在复苏后3 h时最低，以后渐趋好转。结论该模型操作简单、结果稳定、复苏成功率高，是一个较为理想的心肺脑复苏研究模型。
목적：건립일충간단、유효、은정적가토전자격치전심장취정（ CA）후뇌복소모형。방법선용20지신서란웅성가토，채용체표흉벽급심내막하교류전유발실전적방법제작CA모형，CA 4 min후개시심폐복소（CPR）。기록수술조작시간（TOP）、자주순배회복시간（TROSC）、회복솔，제전、신상선소차수，24 h、72 h존활솔이급진행72 h대뇌피질조망세포검측。령취10지토위대조조，지진행치전전수술조작。결과①20지가토전부유발CA성공，실전발생솔위100％。자주순배회복솔위80％；24 h、72 h존활솔위50％、30％；제전화신상선소차수위1．20±0.89、1．60±0．75；TOP화TROSC분별위（79±25）min、（268±33）s。②혈장신경원특이성희순화매（NSE）수평현저승고，ROSC 72 h략유회강，단잉고우조모전（P＜0．05）。③여대조조비교，ROSC후72 h대뇌피질구출현료교다신경세포적조망（P＜0．05）。④신경공능평분（NDS）재복소후3 h시최저，이후점추호전。결론해모형조작간단、결과은정、복소성공솔고，시일개교위이상적심폐뇌복소연구모형。
Objective To establish a simple, effective and stable rabbit brain recovery method on electrically induced fibrillation cardiac arrest (CA).Methods Twenty New Zealand male rabbits were used to set up a rabbit ventricular fibrillation induced CA model by introducing alternating current on the surface under the chest wall and endocardium and then start cardiopulmonary resuscitation (CPR) 4 minutes after CA .The operation time before CPR , restoration of spontaneous circulation ( ROSC ) time, spontaneous circulation response rates , 24 h, 72 h survival rate of the 20 rabbits, the defibrillation frequency , the administration frequency , TOP and TROSC and the apoptotic cells of cerebral cortex on ROSC 72 h have been recorded .For comparison, 10 other rabbits were taken for the surgical operation without fibrillation or CPR .Results ①Cardiac arrest was successfully induced in all 20 rabbits. Incidence of ventricular fibrillation was 100% after electrical stimulation .ROSC rate was 80% and 24 h, 72 h survival rate was 50% (10/20) and 30% (6/20), respectively.The defibrillation frequency was 1.20 ±0.89.The frequency of intravenous injection of adrenaline was 1.60 ±0.75.TOP and TROSC were ( 79 ±25 ) minutes and ( 268 ±33 ) seconds , respectively .②The plasma enzyme specificity enolization of neurons ( NSE) levels increased significantly after building the model .It fell back slightly within 72 hours, but still higher than the level before the model was built (P<0.05).③Apoptosis of nerve cells appeared more in brain cortex after ROSC 72 h than that in the control group (P<0.05).④The lowest NDS was at 3 hours after ROSC , while the NDS increased gradually .The NDS of ROSC 72 h was 72.67 ±9.11 (n=6).Conclusion The rabbit by chest and endocardium induced fibrillation CA model was easy to operate , had stable results and a high recovery rate .It is a relatively ideal cardiopulmonary cerebral resuscitation research model .