大鼠窒息法心搏骤停脑复苏模型的建立与评价.docVIP

大鼠窒息法心搏骤停脑复苏模型的建立与评价 　　【摘要】目的 建立和评价大鼠窒息法心搏骤停脑复苏模型，探讨合适的窒息（AP）时间。方法 实验在中山大学心肺脑复苏研究所完成。126只雄性SD大鼠随机（随机数字法）分为假手术组和实验组，通过静脉注射维库溴铵诱导窒息心搏骤停，实验组根据窒息时间不同分为AP4、AP6和AP8组，分别于心搏停止后4、6、8 min给予机械胸外按压和同步通气复苏。记录复苏基本情况，复苏后1、3、7 d，检测脑含水量、NDS评分、MRI影像学改变、脑组织病理损伤和神经元凋亡。统计分析采用单因素方差分析或χ2检验，以P0.05为差异有统计学意义。结果 复苏后第1天各实验组的NDS评分最低，复苏后3 d脑含水量增加和MRI影像学损伤明显，7 d时脑组织病理损伤和神经元凋亡达到高峰。AP4、AP6和AP8组复苏后24 h存活率分别为85%、75%和45%，AP8组的ROSC率及24 h存活率显著低于AP4和AP6组（P0.01）。随着窒息时间延长，各实验组大鼠复苏后脑水肿及影像学、组织学、神经功能损伤逐渐加重，其中AP8组各指标损伤最严重，AP6组损伤程度适中。结论 成功构建了大鼠窒息法心搏骤停脑复苏模型，结合复苏存活率和脑组织损伤程度，建议将窒息6 min作为该模型合适的缺血时间。 　　【关键词】心搏骤停；心肺脑复苏；窒息；动物模型；脑含水量；神经功能缺损评分；病理损伤；大鼠 　　Studying the establishment of rat model of asphyxial cardiac arrest and the efficacy of CPR Jiang Jun*， Li Kuangyi， Chang Ruiming， Chang Jianxing， Fu Yue， Huang Zitong.*Department of Emergency Medicine， Affiliated Foshan Hospital of Sun Yat-sen University， Foshan Guangdong 528000， China 　　Corresponding author：FU Yue， Email： fuyue75@；Huang Zitong， huangzt@ 　　【Abstract】Objective To study the establishment of rat model of asphyxia-cardiac arrest and efficacy of CPR in order to find the length of optimum time of asphyxia to cause injury.Methods One hundred and twenty-six male Sprague-Dawley rats were randomly（random number） divided into sham operation group and experimental groups. Cardiac arrest was induced by asphyxiation after intravenous injection of vecuronium bromide. The experimental groups were assigned into AP4 （four-minute asphyxia period）， AP6 and AP8 subgroups in accordance with different lengths of time of asphyxia subjected to. In these groups， CPR， including pre-cordial compression and synchronized mechanical ventilation， was initiated 4， 6 and 8 min after asphyxia-induced cardiac arrest， respectively. The successful ratio of resuscitation and hemodynamic variables were recorded. Brain water content， neural deficit scores （NDS）， imaging changes on MR， pathological changes of brain tissue and neuronal apoptosis were evaluated at 1 d， 3 d and 7 days aft