心脏骤停复苏后肾脏功能变化的研究

Study on the changes of kidney function after the cardiopulmonary resuscitation

目的:探讨心脏骤停心肺复苏后肾脏功能的变化规律。方法:将30只兔随机分为假手术组、心脏骤停即刻复苏组和心脏骤停5min组,每组10只。假手术组仅进行麻醉和逆行气管插管、血管穿刺,不进行气管夹闭窒息,心脏骤停组用气管夹闭窒息法致使心跳骤停,分别于心跳骤停后0、5min进行复苏,分别在0、24、48、72h和96h5个时间点取血样,测定血肌酐、胱抑素C的变化,对动物肾脏功能进行评估。结果:即刻复苏组与假手术组比较,各时间点血肌酐轻度升高,但差异无统计学意义;复苏后24h血胱抑素C表达明显增高,然后逐渐降低,复苏后120h血胱抑素C再次升高;各时间点胱抑素C与假手术组比较差异有统计学意义。心跳骤停5min组复苏后各时间点血肌酐、胱抑素C表达明显升高,与假手术组比较差异有统计学意义(P<0.01)。心跳骤停5min组血肌酐以复苏后48h最高,然后逐渐降低,而胱抑素C在复苏后24h即显著升高,持续至复苏后120h仍然处于较高水平。结论:心脏骤停心肺复苏后,肾功能损害出现早,持续时间长,在复苏后120h可能再次出现肾功能损害。

Objective：To investigate the changes of kidney function after the cardiopulmonary resuscitation （CPR）.Method：A total of 30rabbits were divided into three groups：sham operation group,instant resuscitation group and cardiac arrest for 5minutes group.Retrograde tracheal intubation,the right femoral artery catheterization were performed in all rabbits after anaesthetizeation.The tracheal tubes were clipped to cause cardiac arrest except the sham operation group.Then,conventional cardiopulmonary resuscitation was conducted.At five time points of 0,24,48,72and 96hours,the serum level of Cystatin C and creatinine were measured to assess acute kid-ney injury（AKI）.Result：Compared with the sham operation group,expressions of creatinine were slightly in-creased in instant resuscitation group,but there is no significant difference.Expressions of Cystatin C were significantly increased at 24hours after resuscitation（P0.01）,and decreased gradually,but increased again at 120 hours（P0.01）.Compared with the sham operation group,expressions of Cystatin C and creatinine in cardiac arrest for 5minutes group were significantly increased at different time points after resuscitation（P0.01）.Expressions of creatinine peaked at 48hours,then decreased gradually,but expressions of Cystatin C were significantly increased at 24hours,and were at very high level for 120hours compared to those measured in the sham operation group.Conclusion：Kidney injury appeared early and last a long time after CPR,and appeared again at 120 hours after resuscitation.