改良版经心外膜诱颤建立2型糖尿病大鼠心肺复苏模型

Model of cardiac arrest in type 2 diabetes mellitus ratsestablished by modified transcutaneous electrical stimulation on epicardium

目的:探索构建2型糖尿病(T2DM)小动物心肺复苏模型的一种新方法,采用改良后的经心外膜电刺激诱导T2DM大鼠心室颤动,导致大鼠心搏骤停。方法:选择健康的SPF级雄性Sprague-Dawley大鼠40只,体重为(250±10)g。其中10只大鼠作为对照组,给予普通饲料喂养并经腹腔注射同等剂量的柠檬酸钠溶液(PH=4.5);另30只大鼠给予高脂高糖饲料前期喂养,模拟糖尿病患者前驱期的肥胖、胰岛素抵抗和(或)葡萄糖不耐受状态,大鼠T2DM造模成功后,选用针灸针作为导电极,采用定量化定位点经胸壁刺入针灸针至达心外膜,持续交流电刺激诱导心室颤动并维持6 mins,然后给予心肺复苏术:呼吸机辅助通气、胸外心脏按压、静脉推注肾上腺素以及电除颤等。诱颤的电流强度为0.5~1.0 mA,电刺激总时间为3 min,电刺激后心电监护均显示心室颤动,心肺复苏后大鼠均恢复自主心率,实验结束后解剖尸体,肉眼观察未发现心外膜出血点和肺部淤血。结果:24只大鼠造模2周后的血糖为(17.1±3.4)mmol/L,体重为(468.7±10.4)g,符合T2DM。有效电刺激开始后,本实验24只T2DM大鼠全部成功诱发心搏骤停。诱颤的电流强度为(0.6±0.1)mA,电刺激后诱发出现心搏骤停的时间为(20±6)s,室颤导致的心搏骤停的总时间为6 mins,心肺复苏时间为8 mins,除颤次数(3±2)次。实验结束后解剖尸体,肉眼观未发现心外膜出血点和肺部淤血。结论:采用改良后经心外膜诱颤建立2型糖尿病大鼠心搏骤停/心肺复苏模型的操作简单可行,模型稳定,能够满足2型糖尿病患者心搏骤停/心肺复苏基础研究的需要。

Objective:To explore a new method for constructing a small animal cardiopulmonary resuscitation model of type 2 diabetes mellitus(T2 DM),using improved transepicardial electrical stimulation to induce ventricular fibrillation in T2 DM rats,resulting in cardiac arrest in rats.Methods:The experimental site was in the Cardiopulmonary Resuscitation Laboratory of the Second Affiliated Hospital of Anhui Medical University.A total of forty healthy male Sprague-Dawley rats,weighing(250±10)g,were selected.Ten of them were in the control group.The other 30 rats were fed with high-fat and high-sugar diet in the prodromal phase to simulate obesity,insulin resistance,and/or glucose intolerance of diabetic patients.The acupuncture needle was used as the lead electrode.Pierce the acupuncture needle through the chest wall to the epicardium at the quantitative positioning point.Ventricular fibrillation was induced by continuous alternating current stimulation and maintained for 6 minutes,and then cardiopulmonary resuscitation was performed,including ventilator-assisted ventilation,chest compressions,intravenous injection of epinephrine,and electrical defibrillation.The current intensity of the induced fibrillation was 0.5-1.0 mA,and the total time of electrical stimulation was 3 minutes.After electrical stimulation,the ECG monitoring of all rats showed ventricular fibrillation.After cardiopulmonary resuscitation,all rats recovered their voluntary heart rate.No macroscopic subepicardial hemorrhage and marked pulmonary congestion was found at the post-mortem autopsy.Results:Two weeks after STZ establishment,the blood glucose of 24 rats was(17.0±3.3)mmol/L,and the body weight of them was(468.7±10.4)g,meeting the standards of T2 DM rats.After the effective electrical stimulation,cardiac arrest was successfully induced in all 24 T2 DM rats.The current intensity of induced fibrillation is(0.6±0.1)mA,the time to induce cardiac arrest after electrical stimulation is(20±6)s,the total time of cardiac arrest induced by ventricular fibrillation is 6 min,the CPR time is 8 minutes,and the number of defibrillation is(3±2)times.No macroscopic subepicardial hemorrhage and obvious pulmonary congestion was found in the autopsy.Conclusion:The improved method of inducing cardiac arrest/cardiopulmonary resuscitation model in T2 DM rats through transcutaneous electrical stimulation on epicardium is simple and feasible,and the model is stable,which can satisfy the needs of basic research on cardiac arrest/cardiopulmonary resuscitation in T2 DM patients.