窒息法与室颤法复苏模型心脏损伤的比较研究DOI：10.3760/cma.j.issn.1671-0282.2015.01.009基金项目：广东省社会发展计划（2012B031800103）：350001福州，福建省立医院急诊科（何宇敏、赵?觯?;中山大学孙逸仙纪念医院急诊科（黄子通、方向韶、徐雯）通信：黄子通，Email：syxh主题@sina【摘要】目的对比大鼠窒息法和室颤法心搏骤停模型在复苏后不同时期心脏的损伤及恢复情况。方法动物模型在中山大学心肺脑复苏研究所病理生理实验室完成;35只SD雄性大鼠随机（随机数字法）分组制作窒息法与室颤法诱导8min心搏骤停的心肺复苏模型及假手术组，于复苏成功后4、24、72h行心肌HE染色、心肌线粒体呼吸控制率（RCR）、心脏彩超的比较。计量资料用均数±标准差（x±s）表示，两组均数比较采用t检验，多组比较采用单因素方差分析，以P<0.05为差异具有统计学意义。结果HE染色4h室颤组肌溶解较窒息组明显，72h二组肌纤维排列紊乱;RCR4h室颤组低于窒息组，24h恢复且两组间差异无统计学意义;心脏彩超示左室射血分数（LVEF）室颤组4h低于窒息组（29.68%vs.42.16%，P=0.031），24h室颤组与假手术组无异，而窒息组72h方与假手术组间差异无统计学意义，72h两组左室前壁厚度均较假手术组增加（2.41mmvs.1.72mm，P=0.013;2.61mmvs.1.72mm，P=0.007），组间差异无统计学意义。结论室颤模型在复苏后早期心肌损伤较窒息模型严重;中间期两种模型均有所恢复，且室颤组较窒息组更早恢复;复苏后后期两组均出现代偿性心肌肥厚，心功能差异无统计学意义。【关键词】心搏骤停;心肺复苏;室颤;窒息;线粒体呼吸功能;心脏彩超ComparisonofmyocardialinjuresbetweenasphyxiaandventricularfibrillationmodelsofcardiacarrestsHeYumin*，ZhaoShen，HuangZitong，FangXiangshao，XuWen.*EmergencyDepartmentofFu激anProvinialHospital，Fuzhou350001，ChinaCorrespondingauthor：HuangZitong，Email：syxh主题@sina【Abstract】ObjectiveTocomparethedifferenceincardiacinjuriesbetweenasphyxiaandventricularfibrillationmodesindifferentperiodsaftercardiacarrest（CA）.MethodsThemodelwasestablishedinCardiopulmonaryResuscitationLab，SunYat-senUniversity.Atotalof35maleSDratswereusedtoproducetheasphyxiaorventricularfibrillation（VF）cardiacarrestmodelsrandomly.Bothofthetwomodeswereinduced8minutescardiacarrest.ThemyocardialHEstains，mitochondrialrespiratorycontrolratio（RCR），andechocardiographywereobservedat4h，24hand72hafterROSC（restorationofspontaneouscirculation）.Theresultswereexpressedas（x±s），ttestwasperformedtocomparebetweentwogroups，andonewayanalysisofvariancewasusedtocomparemultiplegroups.P<0.05wasconsideredassignificantdifference.ResultsHEstainsshoweddamagesweremoreseriousintheVFmodethaninasphyxiamodeat4h，andbothofthemhadadisorderly-arrangedmyocardiumat72h.RCRinVFmodebecameworseat4h，andRCRresumedat24hinbothmodeswithoutsignificantdifferencecomparedwiththeshamoperatedrats.TheechocardiographyshowedVFmodehadalowerleftventricularejectionfraction（LVEF）thanasphyxiamodeat4h（29.68%vs.42.16%，P=0.03），andtherewasnodifferenceinLVEFbetweenVFmodeandtheshamoperatedratsat24h，howevernodifferenceinLVEFbetweentheasphyxiaandshamoperatedratsat72h.Bothofthemhadathickerleftventricularanteriorwallthantheshamoperatedratsat72h（2.41mmvs.1.72mm，P=0.013;2.61mmvs.1.72mm，P=0.007），andtherewasnosignificantdifferencebetweenthem.ConclusionsTheventricularfibrillationmodehasamoresevereinjuriesinearlyperiod，butitrecoverssoonerthanasphyxiaone.BothoftwogroupsgetcompensatoryleftventricularhypertrophyinlaterperiodofROSC.【Keywords】Cardiacarrest;Cardiopulmonaryresuscitation;Ventricularfibrillation;Asphyxia;Respiratorycontrolratio;Echocardiography猝死一直是威胁人类健康及生命...