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头部重点低温复苏轻伤兔脑神经元的机理探讨 |
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段满林 李德馨 徐建国 王刚 傅素娥
摘要 目的：评价头部重点低温(SHC)能否减轻神经元的再灌流损伤和改善轻伤脑神经元的转归。方法：采用“四血管”模式造成完全性脑缺血30分钟，然后将168只新西兰兔随机分为3组，Ⅰ组为未缺血对照组；其余两组动物的3个亚组在缺血后分别再灌流30、180和360分钟；Ⅱ组为常温再灌流组；Ⅲ组为SHC治疗组(28℃)。检测了脑组织中21项内源性伤害因子的变化，并采用计算机图象分析技术，将神经元区分为A(正常)、B(轻伤)等四类。结果：与Ⅰ组相比，Ⅱ组A类神经元所占百分比在再灌流时进行性下降，B类增多(均P＜0.01)；与Ⅱ组相比，Ⅲ组A类神经元进行性增多，B类也增多；Ⅱ组与A类神经元改变相关的内源性伤害因子是VIP，β-EP，PGl2，T3，T4和Na＋，K＋-ATPase；B类的是β-EP和TXB2(P＜0.05)。Ⅲ组Ca2＋，Mg2＋-ATPase与A类神经元所占百分比变化相关(P＝0.019)。结论：SHC能有效地减轻神经元损伤和复苏轻伤神经元，其主要机理为稳定细胞膜和阻断高代谢状态。
关键词 头部重点低温 脑复苏 再灌流损伤
Mechanism of selective head cooling for resuscitating mildly damaged neuron in rabbits
Duan Manlin，Li Dexin，Xu Jianguo，et al．Department of Anesthesiology，Clinical School of Medical College，Nanijng University or Nanjing General Hospital of PLA，Nanjing 210002
Abstract Objective：To assess whether selective head cooling（SHC）could ameliorate the post-ischemic reperfusion injury．Method：Complete cerebral ischemia（CCI）was induced with the four-vessel model for 30 min．196 New Zealand rebbits were randomly allocated into three groups：group Ⅰserved as nonischemic control；animals in three subgroups of other groups had reperfused lasting 30，180 and 360 min respectively following CCI．Group Ⅱ served as normothermic reperfusion；group Ⅲ treated with selective head cooling（28℃，）．Twenty-one endogenous parameters in brain were determined，and histomorphological assessment of neuronal chanes was observed．Neurons were classified respectively into type A（normal）and B（mild damage）etc．Result：As compared with group Ⅰ，the percentage of type A neurons was progressively decreased，while that of type B neurons increased significantly in group Ⅱ（P＜0．01）；as compared with group Ⅱ，that of type A and B neurons increased in group Ⅲ（P＜0．01）．In the group Ⅱ，the parameters correlating with the changes of type A neurons，were VIP，β-EP，PGI2，T3，T4 and Na＋，K＋-ATPase；those of type B were β-EP and TXB2（P＜0．05）．After selective[1] [2] 下一页
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