兔模型心脏骤停标准的探讨

目的：比较心肺复苏动物模型的2种心脏骤停判断标准,以确立适合于心脏骤停后综合征研究的心脏骤停判断标准。方法：大耳白兔30只,随机分为心电图标准组（A组）、动脉压标准组（B组）。采用夹闭气管建立心脏骤停模型,分别使用2种不同的心脏骤停判断标准,心脏骤停5min时立即复苏,观察复苏成功率和兔存活时间,监测心脏骤停前、复苏后24、48、72、96、120h6个时间点兔血神经元特异性烯醇化酶（NSE）、谷丙转氨酶（ALT）、血肌酐及肌钙蛋白I水平,分析复苏后多器官功能障碍综合征（MODS）发生情况。结果：心肺复苏即刻成功率A组为33%,B组为86%,2组比较有显著差异（P〈0.05）。兔存活时间A组为（1.38±1.04）h,B组存活时间为（58.0±41.5）h,2组比较有显著差异（P〈0.01）。B组兔复苏后24、48、72h时间点血NSE、ALT、肌酐及肌钙蛋白I水平明显升高,与心脏骤停前比较有显著差异（P〈0.01）。复苏后24～72h,兔出现多器官功能障碍综合征（MODS）表现。结论：以平均动脉压为标准判断心脏骤停优于心电图标准,适用于标准化心脏骤停后综合征的兔模型的建立。

An Approach to the Criteria for Judging Cardiac Arrest in a Rabbit Model

Objective：To compare two kinds of criteria for judging cardiac arrest in animal model with cardiopulmonary resuscitation,in order to establish a suitable criteria for post-cardiac arrest syndrome.Methods：A total of 30 rabbits were used to establish the models of acute asphyxial cardiac arrest and were randomly divided into ECG criterion group（group A） and arterial pressure criterion group（group B）.Cardiac arrest was induced by endotracheal tube clamping.Then,CPR was started at the end of 5 minutes intervals after the cardiac arrest was identified.The recovery success rate and animal survival time of both groups were examined.The physiological indexes such as neuron-specific enolase（NSE）,alanine aminotransferase（ALT）,creatinine and cardiac troponin I were measured before cardiac arrest and 24 h,48 h,72 h,96 h and 120 h after resuscitation.Multiple organ dysfunction syndrome（MODS） was monitored after resuscitation.Results：The successful rate of resuscitation was 33% in group A and 86% in group B（P 0.05）.Survival time was（1.38±1.04） hours in group A and（58.0±41.5） hours in group B.There was a significant difference between two groups（P 0.01）.Compare to time point before cardiac arrest,the levels of NSE,ALT,creatinine and cardiac troponin Ⅰ of group B increased markedly at 24 h,48 h and 72 h time points after resuscitation（P 0.01）.MODS presented within 24 h to 72 h after resuscitation in group B.Conclusion：Arterial pressure criteria is superior to ECG criteria for judging cardiac arrest model with post-cardiac arrest syndrome.