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深低温停循环犬间断选择性脑灌注的实验研究(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2006年第2期
页码:
171-173,181
栏目:
基础研究
出版日期:
2006-03-01

文章信息/Info

Title:
Experimental study of intermittent selective antegrade cerebral perfusion during deep hypothermic circulatory arrest
作者:
庄晓飞1赵荣1李彤1蔡振杰1段大为1段维勋1赵生涛1赵凌霞2
1.第四军医大学西京医院心血管外科,陕西 西安 710032; 2.山西医科大学第二医院内分泌科,山西 太原 030001
Author(s):
ZHUANG Xiao-fei1ZHAO Rong1LI Tong1CAI Zhen-jie1DUAN Da-wei1DUAN Wei-xun1ZHAO Sheng-tao1ZHAO Ling-xia2
1.Department of Cardiovascular Surgery, Xijing Hospital, Fourth Military Medical University, Xi′an,Shaanxi 710032, China, 2.Department of Endocrinology, Second Hospital, Shanxi Medical University, Taiyuan,Shanxi 030001, China
关键词:
深低温停循环脑保护脑灌注
Keywords:
deep hypothermic circulatory arrest cerebral protectioncerebral perfusioncanis
分类号:
R651.4
DOI:
-
文献标识码:
A
摘要:
目的 研究深低温停循环(deep hypothermic circulatory arrest ,DHCA)期间行间断选择性脑灌注(intermittent selective antegrade cerebral perfusion,ISACP)脑保护效果及机制。方法 健康成年杂种犬12只,随机分为两组。所有动物都经过DHCA 90 min。A(DHCA)组:单纯行DHCA。B(DHCA+ ISACP)组:DHCA期间行间断选择性脑灌注。两组动物分别于恢复循环后,开颅迅速取大脑海马组织进行流式细胞分析、电镜观察及逆转录-聚合酶链反应(RTPCR)观察不同组别动物海马组织中细胞间黏附分子1(intercellular adhesion molecule1,ICAM1)mRNA的表达。结果 正常细胞百分比:A组(2.5±1.0)%, B组(78.8±6.6)%;早期凋亡细胞百分比:A组(77.8±4.3)%,B组(17.6±5.9)%;坏死细胞百分比:A组(18.2±2.8)%, B组(3.3±0.8)%;死亡细胞百分比:A组(1.5±0.6)%,B组(0.3±0.1)%。两组比较差异均非常显著(P<0.01)。术后脑组织电镜检测提示两组动物都有脑部损害,以A组为重。ICAM1 mRNA的表达,A组高于B组(P<0.01)。结论 长时间DHCA期间可能造成脑的 损害,ISACP可有脑保护作用,从而可减轻长时间DHCA造成的脑损害。
Abstract:
AIM To investigate the protective effects and mechanism of intermittent selective antegrade cerebral perfusion during deep hypothermic circulatory arrest. METHODS Twelve healthy adult dogs were randomly assigned into two groups (6 dogs in each group) and all the animals underwent deep hypothermic circulatory arrest (DHCA) for 90 min. The dogs in group A recieved DHCA only and the dogs in group B received intermittent selective antegrade cerebral perfusion(ISACP)during DHCA. After reperfusion, the hippocampi were removed and then dissociated and measured with flow cytometry to analyze neuron apoptosis. The morphological changes were examined by electronmicroscope and the expressions of ICAM1 mRNA in the hippocampus tissue of different groups were estimated by reversetranscriptase polymerase chain(RT-PCR). RESULTS Normal cell percentage: Group A (2.5±1.0)% and Group B (78.8±6.6)%; early apoptotic cell percentage: Group A (77.8±4.3)% and Group B (17.6±5.9)%; necrotic cell percentage: Group A (18.2±2.8)% and Group B (3.3±0.8)%; dead cell percentage: Group A (1.5±0.6)% and Group B (0.3±0.1)%. There were significantly difference between the two groups (P<0.01). Ultrastructural changes of brain tissue damage could be seen in both groups but the extent of the damage found in group A was more serious. The expression of ICAM-1 mRNA of group A was significantly higher than that of group B. CONCLUSION Our experiment reveals that long duration deep hypothermic circulatory arrest will bring about some damages to the central nervous system and that intermittent selective antegrade cerebral perfusion during deep hypothermic circulatory arrest has some brain protective effects by reducing these damages to some extent.

参考文献/References

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备注/Memo

备注/Memo:
收稿日期:2005-10-24.通迅作者:李彤,主任医师,教授,主要从事心脏瓣膜外科方面的研究Tel:(029 83375311 Email:litongberlin@yahoo.com.cn 作者简介:庄晓飞,医师,硕士 Tel:(029)84775311 Email:zhxfei79@fmmu.edu.cn
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