心脏骤停患者心肺复苏后神经系统保护策略综述
A Review of Neurological Protection Strategies after Cardiopulmonary Resuscitation in Cardiac Arrest Patients
DOI: 10.12677/jcpm.2024.34371, PDF,   
作者: 张 恺：承德医学院研究生院，河北 承德；张国彦*：保定市第一中心医院，河北 保定
关键词: 心脏骤停；心肺复苏；脑功能；预后；Cardiac Arrest； Cardiopulmonary Resuscitation； Brain Function； Prognosis
摘要: 心脏骤停造成的代谢紊乱和缺血–再灌注损伤可对患者的脑神经功能造成损伤，影响预后，这也是患者恢复自主循环后陷入昏迷甚至死亡的重要原因。本文对复苏时治疗措施(胸外心脏按压、药物治疗)和复苏后神经功能预后评估等当前心肺复苏相关研究进行综述，以期为心肺复苏神经功能预后的基础和临床研究提供参考。
Abstract: Metabolic disorders and ischaemia-reperfusion injury caused by cardiac arrest can cause damage to patients’ cerebral neurological function, affecting the prognosis, which is an important reason for patients to fall into coma or even die after the recovery of autonomic circulation. In this paper, we review the current studies related to cardiopulmonary resuscitation (CPR) such as therapeutic measures during resuscitation (thoracic cardiac compression, medication) and post-resuscitation neurological prognosis assessment, with a view to providing references to the basic and clinical studies on the neurological prognosis of CPR.
文章引用：张恺, 张国彦. 心脏骤停患者心肺复苏后神经系统保护策略综述[J]. 临床个性化医学, 2024, 3(4): 2610-2614. https://doi.org/10.12677/jcpm.2024.34371

参考文献

[1] Du, L., Ge, B., Ma, Q., Yang, J., Chen, F., Mi, Y., et al. (2017) Changes in Cardiac Arrest Patients’ Temperature Management after the Publication of 2015 AHA Guidelines for Resuscitation in China. Scientific Reports, 7, Article No. 16087. [Google Scholar] [CrossRef] [PubMed]
[2] Benjamin, E.J., Virani, S.S., Callaway, C.W., et al. (2018) Heart Disease and Stroke Statistics-2018 Update: A Report From the American Heart Association. Circulation, 137, e67-e492.
[3] 吴远斌, 李双磊, 吴扬, 等. 心脏骤停患者心肺复苏后神经系统的评估和监测[J]. 中国体外循环杂志, 2019, 17(1): 61-64.
[4] 吴金波, 杨春兰, 姚振兴, 等. 心脏骤停经心肺复苏后患者血清部分炎症因子的变化与预后关系[J]. 心肺血管病杂志, 2019, 38(12): 1232-1235.
[5] 侯宇, 敖雪, 苏醒. 心肺复苏后脑功能预后评估指标研究进展[J]. 长春中医药大学学报, 2023, 39(6): 699-703.
[6] Yu, S., Xu, J., Wu, C., Zhu, Y., Diao, M. and Hu, W. (2024) Multi-Omics Study of Hypoxic-Ischemic Brain Injury after Cardiopulmonary Resuscitation in Swine. Neurocritical Care. [Google Scholar] [CrossRef] [PubMed]
[7] Suresh, M., Arango, S., Moore, J., Salverda, B., Lick, M., Rojas-Salvador, C., et al. (2024) The Association of Regional Cerebral Oximetry and Neurologically Intact Survival in a Porcine Model of Cardiac Arrest. Resuscitation Plus, 17, Article ID: 100539. [Google Scholar] [CrossRef] [PubMed]
[8] Ding, G., Kuang, A., Zhou, Z., Lin, Y. and Chen, Y. (2024) Development of Prognostic Models for Predicting 90-Day Neurological Function and Mortality after Cardiac Arrest. The American Journal of Emergency Medicine, 79, 172-182. [Google Scholar] [CrossRef] [PubMed]
[9] 章梦一, 周文杰, 余洋洋, 等. 一氧化碳释放分子在眼科疾病中的作用研究进展[J]. 广西医学, 2023, 45(3): 338-341.
[10] Zhao, Y., Yao, Z., Lu, L., Xu, S., Sun, J., Zhu, Y., et al. (2024) Carbon Monoxide-Releasing Molecule-3 Exerts Neuroprotection Effects after Cardiac Arrest in Mice: A Randomized Controlled Study. Resuscitation Plus, 19, Article ID: 100703. [Google Scholar] [CrossRef] [PubMed]
[11] 王慧, 侯庆明. AA147对Aβ诱导的阿尔茨海默病细胞模型的作用[J]. 青岛大学学报(医学版), 2024, 60(2): 190-194.
[12] Yuan, Z., Lu, L., Lian, Y., Zhao, Y., Tang, T., Xu, S., et al. (2022) AA147 Ameliorates Post-Cardiac Arrest Cerebral Ischemia/Reperfusion Injury through the Co-Regulation of the ATF6 and Nrf2 Signaling Pathways. Frontiers in Pharmacology, 13, Article 1028002. [Google Scholar] [CrossRef] [PubMed]
[13] Chen, F., Song, B., Lin, S., Lin, Q., Lin, Y., Qian, X., et al. (2022) Bradykinin Postconditioning Protects Rat Hippocampal Neurons after Restoration of Spontaneous Circulation Following Cardiac Arrest via Activation of the AMPK/mTOR Signaling Pathway. Neural Regeneration Research, 17, 2232-2237. [Google Scholar] [CrossRef] [PubMed]
[14] 梁欢, 黄毓慧, 谷小雨, 等. Alda-1对高糖诱导的心肌成纤维细胞纤维化中晚期糖基化终产物-糖基化终产物受体轴及基质金属蛋白酶9/基质金属蛋白酶抑制剂1的影响[J]. 中国糖尿病杂志, 2023, 31(7): 528-534.
[15] Diao, M., Xu, J., Wang, J., Zhang, M., Wu, C., Hu, X., et al. (2022) Alda-1, an Activator of ALDH2, Improves Postresuscitation Cardiac and Neurological Outcomes by Inhibiting Pyroptosis in Swine. Neurochemical Research, 47, 1097-1109. [Google Scholar] [CrossRef] [PubMed]
[16] Tao, S., Duan, R., Xu, T., Hong, J., Gu, W., Lin, A., et al. (2021) Salvianolic Acid B Inhibits the Progression of Liver Fibrosis in Rats via Modulation of the Hedgehog Signaling Pathway. Experimental and Therapeutic Medicine, 23, Article No. 116. [Google Scholar] [CrossRef] [PubMed]
[17] Ji, Q., Li, Y., Wang, Y., Wang, Z., Fang, L., Shen, L., et al. (2020) Salvianolic Acid B Improves Postresuscitation Myocardial and Cerebral Outcomes in a Murine Model of Cardiac Arrest: Involvement of Nrf2 Signaling Pathway. Oxidative Medicine and Cellular Longevity, 2020, Article ID: 1605456. [Google Scholar] [CrossRef] [PubMed]
[18] 罗俊丽, 徐继洋, 杨航, 等. 膜联蛋白A1拟肽AC2-26调控ERK/NF-κB信号通路改善体外循环血清诱导大鼠肺泡II型上皮细胞损伤[J]. 遵义医科大学学报, 2024, 47(10): 941-948.
[19] 夏崇建, 黄俊杰, 张煜, 等. 膜联蛋白A1的N末端肽Ac2-26对高糖刺激的小鼠巨噬细胞极化的影响[J]. 中国病理生理杂志, 2022, 38(11): 1998-2004.
[20] Gong, J., Tai, Q., Xu, G., Wang, X., Zhu, J., Zhao, X., et al. (2020) Ac2-26 Alleviates Brain Injury after Cardiac Arrest and Cardiopulmonary Resuscitation in Rats via the Enos Pathway. Mediators of Inflammation, 2020, Article ID: 3649613. [Google Scholar] [CrossRef] [PubMed]
[21] Moore, J.C., Bartos, J.A., Matsuura, T.R. and Yannopoulos, D. (2017) The Future Is Now: Neuroprotection during Cardiopulmonary Resuscitation. Current Opinion in Critical Care, 23, 215-222. [Google Scholar] [CrossRef] [PubMed]
[22] Ma, Y., Chen, C., Zhang, S., Wang, Q., Chen, H., Dong, Y., et al. (2017) RNase Alleviates Neurological Dysfunction in Mice Undergoing Cardiac Arrest and Cardiopulmonary Resuscitation. Oncotarget, 8, 53084-53099. [Google Scholar] [CrossRef] [PubMed]
[23] Bachista, K.M., Moore, J.C., Labarère, J., Crowe, R.P., Emanuelson, L.D., Lick, C.J., et al. (2024) Survival for Nonshockable Cardiac Arrests Treated with Noninvasive Circulatory Adjuncts and Head/Thorax Elevation. Critical Care Medicine, 52, 170-181. [Google Scholar] [CrossRef] [PubMed]
[24] Pourzand, P., Moore, J., Metzger, A., Salverda, B., Suresh, M., Arango, S., et al. (2024) Hemodynamics, Survival and Neurological Function with Early versus Delayed Automated Head-Up CPR in a Porcine Model of Prolonged Cardiac Arrest. Resuscitation, 194, Article ID: 110067. [Google Scholar] [CrossRef] [PubMed]
[25] 曹钰, 王智渊, 姚鹏, 等. 心肺复苏基础研究热点与展望[J]. 西部医学, 2023, 38(1): 6-13.