血液滤过改善全脑缺血复灌后损伤的实验研究  

Hemofiltratiou ameliorating reperfusion injury aftercomplete cerebral ischemia: an experimental study

作　　者：周源[1] 马大青 朱姜华 单国谨 许幸[1] 李军[1] 

机构地区：[1]北京医科大学第一医院麻醉学研究室

出　　处：《中华医学杂志》1995年第4期227-229,共3页National Medical Journal of China

基　　金：国家自然科学基金

摘　　要：以高钾停循环心肺转流复苏模型观察血液滤过对脑复苏的影响。１６只家兔随机分为对照组和血液滤过组。实验过程中定时测定血乳酸、脂质过氧化物（ＬＰＯ）、血清铁、血浆中分子物质（ＭＭＳ）的动态变化。实验终采用神经功能缺陷记分（ＮＤＳ）评价神经功能。结果：血乳酸，两组都处于高水平，以对照组更高，但两组比较差异无显著性（Ｐ＞０．０５）；血清铁，对照组复灌后升高、滤过组下降，两组比较差异有非常显著意义（Ｐ＜０．０１）；ＬＰＯ对照组显著升高，滤过组基本无变化，两组差异有显著意义；对照组复灌后ＭＭＳ逐渐升高，而滤过组下降，对应时间组间值比差异显著。对照组（３２±１２）ＮＤＳ高于滤过组（１８±１０）（Ｐ＜０．０１）。表明血液滤过能及时清除缺血再灌后产生的“毒性”物质。另外，由于及时清除了自由基、乳酸、使得催化自由基反应的“自由”铁未增加，从而抑制自由基对组织的损伤改善脑复苏。he effects of hemofiltration on cerebral resuscita-tion were studied by using resuscitation model ofpotassemia-induced cardic arrest and cardiopulmonarybypass. sixteen rabbits were divided into control group(CG) and hemofiltration group (HFG). Blcod lacticacid, lipid peroxidant (LPO), serum iron, middlemolecular substance (MMS) were determined. Neuro-logic deficit score (NDS) system was used to evaluateneurologic function. The level of blcod lactic acid wasincreased in both CG and HFG. It was higher in CGthan in HFG (P>0. 05). Serum iron was increased inCG, however, it was decreased in HFG. The differencebetween the two groups was significant (P<0. 01).LPO was increased significantly in CG and there was noobvious changes in HFG. MMS was increased graduallyduring reperfusion in CG, whereas it was decreased inHFG. There was significant difference in the corre-sponding times of the two groups. NDS of CG washigher than that of HFG (32± 12 vs 18± 10)(P<0.01). These data demonstrate that hemofiltration is ableto eliminate ischemic and reperfusional toxic productstiuickly. Additionally, free iron, agonist factor of cat-alyzing free radical reaction, does not increase becausefree radicals and lactic acid are eleminated quickly, in-hibting free radical tissue injury and improving cerebralresuscitation.

关 键 词：脑复苏 血液滤过 再灌流损伤 病理 动物模型 

分 类 号：R363.27[医药卫生—病理学] R743.305[医药卫生—基础医学]