a-硫辛酸对体外循环诱发犬脑损伤的影响  

Effect of a-lipoic acid on cerebal injury induced by cardiopulmonary bypass in dogs

作　　者：尹光明[1] 梁卫东[2] 姚尚龙[3] 

机构地区：[1]济宁医学院附属医院麻醉科,山东省济宁市272029 [2]济宁医学院附属医院肾内科,山东省济宁市272029 [3]华中科技大学同济医学院协和医院麻醉科

出　　处：《中华麻醉学杂志》2010年第7期881-883,共3页Chinese Journal of Anesthesiology

摘　　要：目的探讨a-硫辛酸对体外循环诱发犬脑损伤的影响。方法健康杂种犬12只，雌雄不拘，体重13．5～17．5k，随机分为对照组（C组）和a-硫辛酸组（L组），每组6只。L组于CPB前即刻静脉注射a-硫辛酸50mg／kg，C组静脉注射等容量生理盐水。全心缺血60min，恢复灌注60min。分别于阻断升主动脉前（T0）、阻断升主动脉30、60min、再灌注30、60min（T1-4）时取股静脉血样，采用酶联免疫吸附双抗体夹心法测定血清，INF—a、S100β蛋白及神经元特异性烯醇化酶（NSE）的浓度。结果与T0时比较，两组，T1-4时血清TNF—a浓度、T2-4时NSE浓度、C组T1-4时S100β蛋白浓度升高（P〈0．05）；与C组比较，L组T1～4时血清TNF-a、S100β蛋白浓度、T2-4时NSE浓度降低（P〈0．05）。C组血清TNF—a与S100β蛋白、NSE浓度成正相关（r=0．706，P〈0．01；r=0．81，P〈0．01）。结论a-硫辛酸可减轻体外循环诱发的犬脑损伤，与其抑制炎性反应有关。Objective To investigate the effect of a-lipoic acid on cerebral injury induced by cardiopulmonary bypass （CPB） in dogs. Methods Twelve adult healthy mengrel dogs of both sexes weighing 13.5-17.5 kg were randomly divided into control group （group C） and a-lopoic acid group （group L） （n = 6 each）. In group L a-lipoic acid 50 mg/kg was injected iv immediately before CPB. The animals were anesthetized with intraperitoneal 2.5 % pentobarbital 25 mg/kg, intubated and mechanically ventilated. PaCO2 was maintained at 35-40 mm Hg. Femoral artery and vein were cannulated and Swan-Ganz catheter was inserted into pulmonary artery for MAP, CVP and CO monitoring and blood sampling. Blood samples were obtained immediately before aortic cross-clamping （T0 , baseline）, at 30 and 60 min after aortic cross-clamping （T1,2） and 30 and 60 min after aortic unclamping （T3,4 ） for measurement of plasma concentrations of TNF-a, S100β protein and neuron-specific enolase （NSE）. Results In group C CPB significantly increased plasma TNF-a, S100β protein and NSE concentrations as compared with the baseline values at TO . Pretreatment with a-lipoic acid significantly attenuated CPB-induced increase in plasma TNF-a, S100β protein and NSE concentrations in group L. Plasma S100β protein and NSE levels were positively correlated with plasma TNF-a level. Conclusion Pretreatment with a-lipoic acid is effective in attenuating CPB-induced inflammatory response and cerebral injury.

关 键 词：抗氧化剂 心肺转流术 脑损伤 

分 类 号：R614[医药卫生—麻醉学]