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目的探讨电除颤对心肌的影响。方法对30头太湖猪进行电除颤,对除颤前及除颤后1、4、12、24、72h电解质(K+、Na+、Cl-)和心肌损伤标志物(AST、LDH、CK、CK-MB、CTnI)的含量进行比较。同时观察72h后处死的猪心肌的病理改变,从而判断心肌损伤程度。结果(1)电解质(K+、Na+、Cl-):除颤后各时间段与除颤前比较,差异无统计学意义(P>0.05)。(2)心肌标志物(AST、LDH、CK、CK-MB、CTn):与除颤前相比,心肌各标志物在除颤后12～72h的不同时间段有不同程度的升高。(3)病理结果:肉眼观察和显微镜检查发现,除颤后心肌有心内膜水肿、心肌出血、局部心肌断裂及退行性病变等病理变化。结论除颤对心肌有一定程度的损害,心肌损伤标志物检测有助于除颤后对心肌损伤的监测。
Objective To investigate the influence of defibrillation on myocardium. Methods Electro-defibrillation was performed on 30 Taihu pigs. The levels of electrolytes (K +, Na +, Cl-) and myocardial injury markers (AST, LDH, CK, CK -MB, CTnI) were compared. At the same time, the pathological changes of porcine myocardium killed after 72h were observed to judge the degree of myocardial injury. Results (1) Electrolytes (K +, Na +, Cl-): There was no significant difference in the time after defibrillation between before and after defibrillation (P> 0.05). (2) Myocardial markers (AST, LDH, CK, CK-MB, CTn): Compared with before defibrillation, the markers of myocardium increased to some extent at different time points of 12-72h after defibrillation. (3) pathological findings: macroscopic and microscopic examination found that myocardial defibrillation has endocardial edema, myocardial hemorrhage, local myocardial rupture and degenerative lesions and other pathological changes. Conclusion Defibrillation can damage the myocardium to a certain extent. The detection of myocardial injury markers can be helpful for the monitoring of myocardial injury after defibrillation.