心跳停止时间对兔心肺复苏后脑损伤的影响

Influence of Cardiac Arrest Time on Brain Injury after Cardiopulmonary Resuscitation in Rabbits

目的:探讨心跳停止时间对心肺复苏后神经元特异性烯醇化酶(NSE)的表达和脑损伤的影响。方法:40只兔气管夹闭窒息法制作心肺复苏模型,心跳骤停后4、5、6min进行复苏,分别在0、24、48、72、96、120h6个时间点测定血清NSE含量,并对兔脑损伤情况进行神经功能评分。结果:心肺复苏后24、48、72、96hNSE表达均明显高于假手术组,48h达峰值;心跳骤停组神经功能评分均明显高于假手术组,以复苏后24h最高;心跳骤停5、6min组间神经功能评分无差异(P>0.05);血清NSE水平与神经功能评分正相关(P<0.01)。结论:血清NSE水平评价CPR后脑损伤灵敏、客观。心跳停止4min复苏后脑组织损伤较轻;停止5min以上,脑组织损伤严重。

Objective To explore the influence of cardiac arrest time on the expression of serum neuron-specific enolase （NSE） and brain injury. Methods The model of cardiopulmonary resuscitation（CPR） were prepared by the method of clipping trachea to asphyxia in 40 rabbits and resuscitation was taken at 4,5,6 minutes after cardiac arrest. The contents of serum NSE were determined at 0,24,48,72,96,120 h, respectively. The neurologic score was taken to evaluate the state of brain injury. Results The expression of NSE in resuscitation group was all significantly higher than those of sham-operated group at 24,48,72 and 96 h, and reached peak at 48 h. The neurologic score in arrest group was significantly higher than that of sham-operated group and reached peak at 24 h after resuscitation, and it had no significant difference between arrest for 5 or 6 minutes （P 〉 0.05 ）. The neurologic score and the expression level of NSE were positively correlated（ P 〈 0.01 ）. Conclusion The level of serum NSE was sensitive and objective for brain injury evaluation after CPR. Brain injury was mild if resuscitation was taken within 4 minutes after cardiac arrest, but it was developed to severe for over 5 minutes.