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首页 > 过刊浏览>2020年第30卷第7期 >65-71. DOI:10. 3969 / j.issn.1671-7856. 2020. 07. 009
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窒息法致大鼠心脏骤停-心肺复苏模型造模成功率与生存率影响因素的探讨
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1.广州中医药大学第二附属医院,广东省中医院,广东省中医急症研究重点实验室,广州 510120; 2.广州中医药大学,广州 510006; 3.广州中医药大学深圳医院,广东 深圳 518034; 4.江门市五邑中医院,广东 江门 529000


Factors associated with the return of spontaneous circulation and increased survival in a rat model of cardiac arrest-cardiopulmonary resuscitation induced by asphyxia
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1.the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangdong Provincial Key Laboratory of Research on Emergency in TCM, Guangzhou 510120, China. 2.Guangzhou University of Chinese Medicine, Guangzhou 510006. 3. Shenzhen Hospital of Guangzhou University of Chinese Medicine, Shenzhen 518034. 4. Wuyi Traditional Chinese Medicine Hospital of Jiangmen, Jiangmen 529000

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    摘要:

    目的 通过对窒息法大鼠心脏骤停-心肺复苏(CA-CPR)模型的观察,探讨影响大鼠 CA-CPR 模型 造模成功率与预后的相关因素。 方法 将 50 只 SD 大鼠根据其体重分为Ⅰ组(10 只,250~ 300 g)、Ⅱ组(30 只,300 ~ 350 g)、Ⅲ组(10 只,350~ 400 g),通过窒息法建立 CA-CPR 模型,记录并比较三组大鼠基线资料、大鼠自主循环恢 复(ROSC)成功率、心肺复苏(CPR)时间、ROSC 后的血流动力学情况等。 结果 Ⅰ组、Ⅱ组、Ⅲ组 ROSC 成功率分 别为 90. 00%(9 / 10)、60. 00%( 18 / 30)、60. 00% ( 6 / 10),无统计学差异( P > 0. 05)。 Ⅰ组的 CPR 时间( 365. 16 ± 76. 66)s,与Ⅱ组(417. 19±92. 00)s、Ⅲ组(60. 80±115. 40)s 比较,均存在统计学差异(P <0. 05)。 ROSC 后的血流动 力学比较,Ⅰ组大鼠在 ROSC 后第 30 min 的心率(HR)比Ⅱ组大鼠((306. 22±41. 99) 比(264. 47±33. 28)次/ 分), 存在统计学差异(P <0. 05),余时间段比较无统计学差异(均 P >0. 05)。 多因素二分类 Logistic 回归分析,将体重、 肛温、HR、平均动脉压、窒息致心脏骤停(ACA)时间、CA 持续时间,分别纳入是否 ROSC(χ2= 25. 115,P <0. 001)、是 否存活 72 h(χ2= 14. 191,P = 0. 001)的获得的回归方程具有统计学意义。 其中 ROSC 与 ACA 时间 OR 为 1. 087, 95%置信区间(95% CI):1. 031-1. 146;存活 72 h 与体重 OR = 0. 953,95% CI:0. 915-0. 992、HR OR = 0. 957,95% CI:0. 921-0. 994。 结论 在标准造模条件下,体重较轻的成年鼠,具有较高的可能实现 ROSC 并成功建模;大鼠的 基线心率、体重与大鼠的生存结局成负相关,ACA 时间与良好的结局呈正相关。

    Abstract:

    Objective To explore factors affecting the success of and prognosis for cardiac arrest-cardiopulmonary resuscitation (CA-CPR) in a rat model induced by asphyxia. Methods The CA-CPR model was established in 50 SD rats, which were divided into three groups according to weight: group Ⅰ (n = 10, 250~ 300 g), group Ⅱ (n = 30, 300~ 350 g), and group Ⅲ (n = 10, 350~ 400 g). Baseline data, the rate of return of spontaneous circulation (ROSC), and the time needed for cardiopulmonary resuscitation (CPR) were recorded, and the hemodynamics after ROSC were assessed. Results The ROSC rates for group Ⅰ, group Ⅱ, and group Ⅲ were 90. 00% (9 / 10), 60. 00% (18 / 30), and 60. 00% (6 / 10), respectively, and were not significantly different (P >0. 05). Compared with group Ⅱ (417. 19 ± 92. 00) s and group Ⅲ (60. 80 ± 115. 40)s, group Ⅰ exhibited a significantly shorter CPR time ( 365. 16 ± 76. 66; P < 0. 05). The heart rate (HR) of rats in group Ⅰ (306. 22±41. 99 beats/ min) 30 minutes after ROSC was significantly different to that of rats in group Ⅱ ( 264. 47± 33. 28 beats/ min; P < 0. 05), and there were no significant differences between the other groups (all P>0. 05). A binary logistic regression model was used to evaluate the predictive index for ROSC (χ2= 25. 115, P <0. 001) and 72-hour survival (χ2= 14. 191, P = 0. 001). Six items were included: body weight, anal temperature, HR, mean arterial pressure, asphyxia to cardiac arrest (ACA) time, and CA duration. ROSC was positively correlated with ACA time (OR= 1. 087, 95% confidence interval (95% CI): 1. 031-1. 146); and 72-hour survival was negatively related to body weight (OR= 0. 953, 95% CI: 0. 915-0. 992) and HR (OR = 0. 957, 95% CI: 0. 921-0. 994). Conclusions Our findings show that rats with lower weight, lower baseline HR, and longer ACA time were more likely to have a good outcome.

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曾瑞峰,钟悦嘉,赖成志,赖 芳,刘相圻,段云彪,李尊江,吴炎华,李 俊,丁邦晗.窒息法致大鼠心脏骤停-心肺复苏模型造模成功率与生存率影响因素的探讨[J].中国比较医学杂志,2020,30(7):65~71.

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  • 收稿日期:2019-12-16
  • 在线发布日期: 2020-08-25
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