CAJ | 학술논문

目的通过脑磁共振成像(MRI)检查评价增强型体外反搏(EECP)干预对心脏骤停(CA)自主循环恢复后(ROSC)犬脑水肿及脑血流的影响.方法 16只比格犬,采用心外膜电致颤诱发心搏骤停,ROSC后随机(随机数字法)分为对照组和EECP干预组,各8只.于致颤前和ROSC后连续3d采用扩散加权成像(DWI)和灌注加权成像(PWI)进行4次脑MRI扫描.并记录动脉内血压、单侧颈总动脉流量、颅内微循环灌注量.两组间依据正态检验结果用t检验或用秩和检验.结果与对照组相比,EECP对平均动脉压无明显影响(P＞0.05),但可增加单侧颈总动脉血流量(P＜0.05),增加颅内微循环灌注量(P＜0.05).EECP增加复苏后当天、第3天水分子表观弥散系数值(ADC) (P ＜0.05),增加复苏后当天、第2天、第3天相对脑血流量与基础值比值(RCBF/ Baseline) (P＜0.05).结论 EECP能改善心搏骤停自主循环恢复后犬脑组织血流灌注,减轻脑水肿,从而减轻复苏后脑损伤.
목적 통과뇌자공진성상(MRI)검사평개증강형체외반박(EECP)간예대심장취정(CA)자주순배회복후(ROSC)견뇌수종급뇌혈류적영향.방법 16지비격견,채용심외막전치전유발심박취정,ROSC후수궤(수궤수자법)분위대조조화EECP간예조,각8지.우치전전화ROSC후련속3d채용확산가권성상(DWI)화관주가권성상(PWI)진행4차뇌MRI소묘.병기록동맥내혈압、단측경총동맥류량、로내미순배관주량.량조간의거정태검험결과용t검험혹용질화검험.결과 여대조조상비,EECP대평균동맥압무명현영향(P＞0.05),단가증가단측경총동맥혈류량(P＜0.05),증가로내미순배관주량(P＜0.05).EECP증가복소후당천、제3천수분자표관미산계수치(ADC) (P ＜0.05),증가복소후당천、제2천、제3천상대뇌혈류량여기출치비치(RCBF/ Baseline) (P＜0.05).결론 EECP능개선심박취정자주순배회복후견뇌조직혈류관주,감경뇌수종,종이감경복소후뇌손상.
Objective To investigate the therapeutic effects of enhanced external counterpulsation (EECP) on cerebral edema and cerebral blood flow perfusion with MRI following cardiac arrest (CA) and on successful return of spontaneous circulation (ROSC) by cardiopulmonary resuscitation (CPR) in dogs.Methods Sixteen beagle dogs were induced CA with alternating current on epicardium,then were randomly (random number) divided into the EECP and control group after successful ROSC.MR scanning brain of all animals was carried out by diffusion-weighted imaging (DWI) and perfusion weighted imaging (PWI) before CA and on the first,second and third days after ROSC.Blood pressure,right common carotid artery flow,and intracranial microcirculation perfusion were measured.Results There were no significant differences in mean artery pressure at all intervals between two groups (P ＞ 0.05).There was significant increase in right common carotid artery blood flow and intracranial microcirculation of dogs in EECP group compared with the control group (P ＜ 0.05).Apparent diffusion coefficients (ADC) of water molecule on the first and third days after ROSC were significantly higher in the EECP group than those in the control group (P ＜ 0.05).Ratios of post-ROSC relative cerebral blood flow (RCBF) /original cerebral blood flow were higher in the EECP group than those in the control group on the first,second and third days after ROSC (P ＜ 0.05).Conclusions EECP treatment could improve cerebral blood flow perfusion and relieve ischemic cerebral edema,alleviating brain injury in dogs following CA and successful ROSC.