亚低温对脊髓缺血再灌注损伤的保护及机制的研究  

Role of Moderate Hypothermia in Spinal Cord Ischemia-reperfusion Injury in Rabbits

作　　者：张亚峰[1] 杨惠林[1] 唐天驷[1] 张洪涛[1] 

机构地区：[1]苏州大学附属第一医院骨科,江苏苏州215006

出　　处：《苏州大学学报（医学版）》2005年第1期54-56,59,共4页Suzhou University Journal of Medical Science

摘　　要：目的研究亚低温对兔脊髓缺血再灌注损伤的保护作用及机制。方法(1)采用腰动脉阻断法制作脊髓缺血动物模型。20只兔均分为常温和亚低温组,缺血40min后于再灌注0.5、4、8、12、24、48h6个时段观察神经功能变化并进行评级和评分。(2)兔18只,假手术组2只,常温和亚低温组各8只,常温和亚低温组在缺血40min后于再灌注4、8、12、24h4个时段采集损伤节段脊髓组织HE染色,光镜下观察。结果(1)缺血40min后,均出现下肢瘫痪,恢复血供后有部分恢复。随着再灌注时间的延长,神经功能逐渐恶化,并与再灌注时间成正比。亚低温组神经功能明显优于常温组(P<0.05)。(2)随着再灌注时间的延长,脊髓损伤的组织病理变化逐渐加重,但在各再灌注时间段,亚低温组脊髓损伤均较常温组为轻。结论脊髓神经功能的恶化与再灌注时间的延长成正相关。31℃-33℃系统亚低温能够明显改善缺血再灌注后神经功能的恶化,是保护脊髓缺血再灌注损伤较好的方法。减少IL-8在脊髓组织中的表达,抑制再灌注后继发炎症反应是其可能机制。Objective To study the role and mechanism of moderate hypothermia in spinal cord ischemia-reperfusion injury in rabbit. Methods (l)The spinal cord ischemia-reperfusion model was developed by occluding lumbar arteries. Twenty rabbits were randomly divided into normothermia and hypothermia groups. Reperfusion for 0.5, 4, 8, 12, 24 and 48 h followed 40 min ischemia in two groups respectively. The locomotor and spinal function was evaluated by the Jacobs methods, and sensory, motor and reflex function of spinal cord were scored by the Reuter methods. (2) Using the same model, and after the reperfusion for 4, 8, 12 and 24 h, the damage regions of spinal cord were removed and stained with HE and immurohistochemical to observe the histopathologic changes and expression of IL-8. Results (1) After 40 min ischemia, paralysis of legs could be observed, then there was periodical recovery after blood reflow. But deterioration of spinal and locomotor functions was directly proportional to time of reperfusion. In moderate hypothermia group, the functional deficit was less than that in normothermia group in each period (P<0.05). (2) The histopathologic exacerbation, positive expression of IL-8 and PMNL aggregation in spinal tissues increased following the reperfusion and in different phase in hypothermia group they were less than that in normothermia group. Conclusion There is positive corelation between the neuropathological deficit of spinal cord and progress of reperfusion. The systemic hypothermia of 31 ℃ to 33℃ can alleviate the functional deterio- rations evidently. It is an effective treatment for ischermia-reperfusion injury of spinal cord. Diminishing the expression of IL-8 and inhibiting the secondary inflammation may be one of the mechanisms.

关 键 词：脊髓 缺血再灌注损伤 亚低温 兔 

分 类 号：R744.105[医药卫生—神经病学与精神病学]