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目的:探讨心脏骤停心肺复苏后肾脏功能的变化规律。方法:将30只兔随机分为假手术组、心脏骤停即刻复苏组和心脏骤停5min组,每组10只。假手术组仅进行麻醉和逆行气管插管、血管穿刺,不进行气管夹闭窒息,心脏骤停组用气管夹闭窒息法致使心跳骤停,分别于心跳骤停后0、5min进行复苏,分别在0、24、48、72h和96h5个时间点取血样,测定血肌酐、胱抑素C的变化,对动物肾脏功能进行评估。结果:即刻复苏组与假手术组比较,各时间点血肌酐轻度升高,但差异无统计学意义;复苏后24h血胱抑素C表达明显增高,然后逐渐降低,复苏后120h血胱抑素C再次升高;各时间点胱抑素C与假手术组比较差异有统计学意义。心跳骤停5min组复苏后各时间点血肌酐、胱抑素C表达明显升高,与假手术组比较差异有统计学意义(P<0.01)。心跳骤停5min组血肌酐以复苏后48h最高,然后逐渐降低,而胱抑素C在复苏后24h即显著升高,持续至复苏后120h仍然处于较高水平。结论:心脏骤停心肺复苏后,肾功能损害出现早,持续时间长,在复苏后120h可能再次出现肾功能损害。
Objective: To investigate the changes of renal function after cardiac arrest in cardiopulmonary resuscitation. Methods: Thirty rabbits were randomly divided into sham operation group, immediate cardiac arrest group and cardiac arrest 5 min group. Sham-operation group was only anesthesia and retrograde tracheal intubation, vascular puncture, without tracheal asphyxia, cardiac arrest group with tracheal asphyxiation caused by sudden cardiac arrest, respectively, 0,5min after cardiac arrest resuscitation, respectively Blood samples were taken at 0, 24, 48, 72h and 96h time points to determine the changes of serum creatinine and cystatin C, and the renal function of the animals was evaluated. Results: Compared with the sham operation group, serum creatinine increased slightly at each time point after immediate resuscitation, but the difference was not statistically significant. The expression of cystatin C increased significantly at 24h after resuscitation and then gradually decreased, C once again increased; at each time point cystatin C and sham operation group difference was statistically significant. The levels of serum creatinine and cystatin C were significantly increased at 5 min after cardiac arrest in 5 min after resuscitation, which was significantly different from that in sham operation group (P <0.01). Serum creatinine was the highest at 48 hours after resuscitation in 5 minutes after cardiac arrest, and then decreased gradually. Cystatin C increased significantly at 24h after resuscitation and continued to a high level at 120 hours after resuscitation. CONCLUSIONS: Cardiac arrest after cardiopulmonary resuscitation has early and long-lasting renal damage, and renal damage may occur again 120 h after resuscitation.