CAJ | 학술논문

目的观察经机械胸外按压心肺复苏术(MCPR)后,猪离体心脏分别在按压及低温间断灌注保存24 h后,冠状动脉内皮细胞功能改变.方法健康瑞典家猪24头,随机分为对照组、按压组、间断灌注保存组3组,每组8头.对照组直接取心脏冠状动脉左前降支远端血管环行器官浴槽实验；后两组均先行人工诱导室颤,用自动心脏按压器(Lucas)行MCPR,20 min后电击除颤,心脏血流稳定且恢复至除颤前水平后,按压组切取心脏冠状动脉左前降支远端血管环立即进行器官浴槽实验；间断灌注组切取心脏后在保存容器中进行低温间断灌注保存24 h,再切取心脏冠状动脉左前降支远端血管环进行器官浴槽实验.评价3组冠状动脉内皮依赖性舒张(EDR)的变化.结果 3组最大内皮依赖性舒张(EDRmax)分别为(98.37 ±1.51)％、(95.50±1.07)％、(53.25±10.98)％(F=19.35,P＜0.01)；50％最大舒张时P物质的浓度对数(pEC50)分别为6.50±0.33、6.40±0.23、5.79±0.33(F =5.05,P＜0.05).与对照组及按压组比较,间断灌注组EDRm=与pEC50均降低(P＜0.05),前两组间的EDRmax与pEC50差异无统计学意义(P＞0.05).结论用Lucas行MCPR后短时间内对离体心脏冠状动脉内皮功能损伤不明显,间断灌注保存组心脏冠状动脉内皮功能有损伤,提示按压后长时间的保存对离体冠状动脉内皮功能的影响较大.
목적 관찰경궤계흉외안압심폐복소술(MCPR)후,저리체심장분별재안압급저온간단관주보존24 h후,관상동맥내피세포공능개변.방법 건강서전가저24두,수궤분위대조조、안압조、간단관주보존조3조,매조8두.대조조직접취심장관상동맥좌전강지원단혈관배행기관욕조실험；후량조균선행인공유도실전,용자동심장안압기(Lucas)행MCPR,20 min후전격제전,심장혈류은정차회복지제전전수평후,안압조절취심장관상동맥좌전강지원단혈관배립즉진행기관욕조실험；간단관주조절취심장후재보존용기중진행저온간단관주보존24 h,재절취심장관상동맥좌전강지원단혈관배진행기관욕조실험.평개3조관상동맥내피의뢰성서장(EDR)적변화.결과 3조최대내피의뢰성서장(EDRmax)분별위(98.37 ±1.51)％、(95.50±1.07)％、(53.25±10.98)％(F=19.35,P＜0.01)；50％최대서장시P물질적농도대수(pEC50)분별위6.50±0.33、6.40±0.23、5.79±0.33(F =5.05,P＜0.05).여대조조급안압조비교,간단관주조EDRm=여pEC50균강저(P＜0.05),전량조간적EDRmax여pEC50차이무통계학의의(P＞0.05).결론 용Lucas행MCPR후단시간내대리체심장관상동맥내피공능손상불명현,간단관주보존조심장관상동맥내피공능유손상,제시안압후장시간적보존대리체관상동맥내피공능적영향교대.
Objective To study the function change of pig heart coronary artery endothelial cells after the rescue of mechanical chest compressions cardiorespiratory resuscitation (MCPR),the isolated heart press and low-temperature intermittent infusion for 24 hours.Methods 24 healthy Swedish domestic pigs were randomly divided into3 group which including control group,pressing group,intermittent perfusion preservation group (n =8,every group).Control group were directly taken heart left anterior descending artery distal vascular ring organ baths experiment.The other two groups were first artificially induced ventricular fibrillation,then MCPR were taken with automatic cardiac massage (Lucas),defibrillate after 20 minutes to make cardiac blood flow stably and restore to status of before defibrillation.The pressing group were taken organ baths experiment after cut heart left anterior descending artery distal vascular ring immediately.The intermittent perfusion group were taken organ baths experiment after the hearts were intermittent perfusion for 24 hours in container and cut the heart left anterior descending coronary the distal vascular ring.At last,coronary artery endothelium dependent relaxation (EDR) changes were evaluated.Results The maximum endothelium-dependent relaxation (EDRmmax) were (98.37 ± 1.51)％,(95.50 ±1.07) ％,(53.25 ± 10.98) ％ (F =19.35,P ＜ 0.01) ; The concentration logarithmic of P substance when 50％ maximal relaxation (pEC50) were (6.50 ± 0.33),(6.40 ± 0.23),(5.79 ± 0.33) (F =5.05,P ＜ 0.05).Compared with the control group and the press group,the EDRmax and pEC50 of intermit tent perfusion group both were lower (P ＜ 0.05),no significant difference between the two groups foward (P ＞ 0.05).Conclusion There is no obvious hurt on the isolated heart coronary endothelial dysfunction shortly after MCPR with Lucas.The long time store of isolated heart might heavily affect the heart coronary endothelial function,because there' s obvious hurt in the intermittent perfusion preservation group.