脑微透析法监测动脉瘤术中临时阻断对脑局部兴奋性氨基酸水平的影响  

Effects of temporary arterial occlusion on levels of excitory amino acids in the regional brain in aneurysm surgeries: studys with microdialysis

作　　者：李健[1] 陈劲草[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院神经外科,武汉市430030

出　　处：《实用医学杂志》2006年第8期885-887,共3页The Journal of Practical Medicine

摘　　要：目的:应用微透析技术研究动脉瘤显微手术中临时阻断载瘤动脉前后患者脑细胞间液中兴奋性氨基酸(EAA)水平的变化规律,了解临时阻断前后脑血流的改变对脑生化代谢的影响。方法:选取18例行术中临时阻断的开颅动脉瘤夹闭术患者,术中将微透析探针置入相应载瘤动脉供血的脑皮质中,Ringer's液为灌流液,灌流速度2μL/min,分别于临时阻断开始前和阻断后每间隔10min采样1次,收集微透析液标本并用高效液相色谱(HPLC)法检测其中谷氨酸(Glu)、天冬氨酸(Asp)的含量。结果:载瘤动脉临时阻断后10min内Glu、Asp的含量与阻断前相比变化不明显(P>0.05),临时阻断后10～20min时已明显升高(P<0.05),20min后水平升高较阻断前差异有极显著性(P<0.01)。结论:应用微透析技术可以从细胞代谢的分子水平监测临时阻断对EAA水平的影响,随临时阻断时间的延长EAA显著升高,术中应尽量少用临时阻断并缩短阻断时间。Objective To observe the effects of temporary arterial occlusion on levels of excitory amino acids （EAAs） in the regional brain in aneurysm surgical patients with microdialysis. Methods Eighteen patients needing temporary arterial occlusion in intracranial aneurysm surgeries were selected. The microdialysis probes were punctured into the cerebral cortices in the operation of clipping aneurysm to perfuse Ringer＇s solution and collect fluid for mierodialysis （perfusion speed： 2μL/min） once every 10 minutes before and after temporary occlusion. The collected fluid was tested by HPLC for examining the values of Glu and Asp. Result Glu and Asp contents in the cerebral cortices had no significant changes（ P 〉 0. 05） at 0 - 10 min after temporary arterial occlusion, increased significantly at 10 ～ 20 min, after 20 min（ P 〈 0.05, P 〈 0.01, respectively） . Conclusions With microdialysis, the changes of EAAs can be monitored from the molecular level of cell metabolism in aneurysm microsurgefies before and after temporary arterial occlusion. EAAs increase significantly after temporary occlusion. So, the use and the time of the temporary occlusion should be reduced and shortened.

关 键 词：动脉瘤 微透析 临时阻断 兴奋性氨基酸 

分 类 号：R651.1[医药卫生—外科学]