摘要
目的明确亚低温疗法对复苏后家兔心功能不全的影响。方法通过体外致颤法建立家兔心肺复苏模型，20只健康家兔随机分为常温复苏组（A组，n=10）与亚低温复苏组（B组，n=10）。常温复苏组在常温状态下行标准心肺复苏，整个实验过程中家兔体温维持在正常体温38．3℃～39．2oC；亚低温复苏组在常温下行标准心肺复苏至自主循环恢复（ROSC）后快速诱导亚低温，亚低温诱导采用从家兔耳缘静脉以1．0ml／（kg·min）速度泵人4．0℃生理盐水，同时配合体表降温方法，约10～15min后降至目标温度32℃～34℃。动态观察左室舒张末压（LVEDP）、左室内压上升和下降最大速率（＋dp／dtmax）以及血清心型脂肪酸结合蛋白（H—FABP）浓度变化。结果①与致颤前相比，两组LVEDP值在复苏后各时间点均有不同程度升高，±dp／dtmax值均有不同程度降低（均P〈0．01），但B组LVEDP升高幅度及＋dp／dtmax下降幅度均小于A组（均P〈0．05）；②与致颤前比较，两组血清H—FABP值在复苏后各时间点明显上升（均P〈0．01），但B组H—FABP值升高幅度明显小于A组（均P〈0．05）。结论亚低温治疗能够减轻复苏后心肌损伤，改善家兔复苏后心功能不全，具有复苏后心肌保护作用。
Objective To observe the effects of mild hypothermia on postresuscitation myocardial dysfunction. Methods After setting up rabbit model of cardiopulmonary resuscitation, 20 rabbits were randomly divided into two groups, normothermic resuscitation group （NORM） in which the animals were performed standard CPR after cardiac arrest, and post-ROSC hypothermia group （PRH） in which the animals were cooled to 32-34°C after successful ROSC. The left ventricular end-diastolic pressure （LVEDP） and left ventricular pressure rise-fall rate （±dp/dt max）, serum concentrations of heate-type, and fatty acid-binding protein （H-FABP） were observed. Results Compared with the NORM group, the PRH group had significantly better hemodynamic values and lower serum H-FABP levels at the early stage of post-resuscitation （both P〈0.05）. Conclusion Mild hypothermia attenuated postesuscitation myocardial dysfunction during the early period of post-resuscitation.
出处
《中国急救复苏与灾害医学杂志》
2012年第5期431-433,448,共4页
China Journal of Emergency Resuscitation and Disaster Medicine
关键词
心肺复苏
亚低温
复苏后心功能不全
Cardiopulmonary resuscitation
Mild hypothermia
Postresuscitation myocardial dysfunction
