室颤时冠脉灌注压和室颤波形对自主循环恢复的预测研究

山东大学学报(医学版) ›› 2011, Vol. 49 ›› Issue (2): 54-.

室颤时冠脉灌注压和室颤波形对自主循环恢复的预测研究

李景莎，钟敬泉，刘红臻，曾绮娴，苏国英，孟祥林，刘东林，张运

山东大学齐鲁医院心内科, 济南 250012

收稿日期:2010-11-04 出版日期:2011-02-10 发布日期:2011-02-10
通讯作者: 钟敬泉，主任医师，博士生导师，主要从事心脏电生理和心功能的基础和临床研究。 E-mail： zwky1668@vip.sina.com
作者简介:李景莎（1985- ），女，硕士研究生，主要从事室颤心肺复苏的研究。
基金资助:
国家自然科学基金资助项目（30871039）。

Coronary perfusion pressure during ventricular fibrillation and waveform-based indicators for the return of spontaneous circulation

LI Jing-sha, ZHONG Jing-quan, LIU Hong-zhen, ZENG Qi-xian, SU Guo-ying, MENG Xiang-lin, LIU Dong-lin, ZHANG Yun

Department of Cardiology, Qilu Hospital, Shandong University， Jinan 250012, China

Received:2010-11-04 Online:2011-02-10 Published:2011-02-10

摘要/Abstract

摘要：

目的评估心肺复苏前室颤时的冠脉灌注压和室颤波形对自主循环恢复的预测价值。方法将20头家猪采用体外电击法制备动物室颤模型，室颤维持8min后依次给予2min心肺复苏和电除颤。将实验后的动物分为自主循环恢复组和自主循环未恢复组。记录室颤时的血流动力学以及室颤波的平均频率和振幅。结果自主循环恢复组的血流动力学、室颤波的平均频率和振幅明显高于自主循环未恢复组（P均<0.05）；室颤时的冠脉灌注压和室颤波的平均频率和振幅对ROSC均有较高的预测价值（ROC曲线下面积：0.86，0.76，0.82）。室颤波的平均频率和振幅与冠脉灌注压呈正相关（r=0.67；r=0.71，P均<0.01）。结论心肺复苏前室颤时的冠脉灌注压和室颤波形可预测自主循环恢复。

关键词: 心室颤动；模型，动物；心肺复苏；冠脉灌注压；平均频率；平均振幅；自主循环恢复

Abstract:

Objective To evaluate whether coronary perfusion pressure （CPP） during untreated ventricular fibrillation (VF) and the corresponding VF waveform could be used to predict the probability of return of spontaneous circulation (ROSC). Methods VF was electrically induced and sustained for 8 minutes followed by 2 minutes of cardiopulmonary resuscitation and defibrillation in 20 pigs. Hemodynamics, VF mean frequency (VFmf) and VF mean amplitude (VFma) during untreated VF were analyzed by a multipurpose polygraph. According to the outcomes, the animals were categorized into the ROSC or the noROSC group. Results There were 7 animals in ROSC group and 13 in no-ROSC group. Among ROSC animals, hemodynamic variables were better and both VFmf and VFma were higher than those of the no-ROSC animals (P<0.05). CPP, VFmf and VFma during untreated VF could be used to predict the probability of ROSC (area of ROC curve: 0.86, 0.76, and 0.82, respectively). Both VFmf and VFma showed positive correlations with CPP (r=0.67, r=0.71, respectively; P<0.01). Conclusions Both CPP and VF waveform during untreated VF are valuable indicators for ROSC.

Key words: Ventricular fibrillation; Model, animals; Cardiopulmonary resuscitation; Coronary perfusion pressure; Mean frequency; Mean amplitude; Return of spontaneous circulation

中图分类号:

R541.78

李景莎，钟敬泉，刘红臻，曾绮娴，苏国英，孟祥林，刘东林，张运. 室颤时冠脉灌注压和室颤波形对自主循环恢复的预测研究[J]. 山东大学学报(医学版), 2011, 49(2): 54-.

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