不同程度血管内热交换降温对犬重型创伤性脑损伤的影响  

Effects of endovascular cooling in different degrees on severe tramnatic brain injury in dogs

作　　者：孙剑[1] 杨志遐 岳生[3] 孙红梅[1] 王志萍[4] 

机构地区：[1]江苏省淮安市妇幼保健院麻醉科,223002 [2]河北省邢台市清河县人民医院麻醉科 [3]苏州市立医院东区麻醉科 [4]南京医科大学附属无锡人民医院麻醉科

出　　处：《中华麻醉学杂志》2012年第4期416-419,共4页Chinese Journal of Anesthesiology

基　　金：江苏省教育厅重大课题（08KJA320001）;江苏省卫生厅重大科研项目（H200723）;江苏省自然科学基金（BK2009090）

摘　　要：目的评价不同程度血管内热交换降温对犬重型创伤性脑损伤的影响。方法健康杂交家犬18只，雌雄不拘，体重12～15kg，采用随机数字表法，将其随机分为31℃低温组（A组）、35℃低温组（B组）和未降温组（c组），每组6只。采用改进的fenney法制备犬重型颅脑外伤模型，A组和B组行血管内热交换降温，时间6h，C组不给予降温。于打击前（T0）和打击后24h（T1）、48h（T2）、72h（T1）时采集脑脊液，采用ELISA法测定脑脊液神经元特异性烯醇化酶（NSE）、S-100β和髓鞘碱性蛋白（MBP）的浓度，采用高效液相法测定犬脑脊液天冬氨酸（Asp）、谷氨酸（Glu）、甘氨酸（Gly）、γ-氨基丁酸（GABA）的浓度。结果与C组比较，A组和B组T1-3时脑脊液NSE、S-100β、MBP、Asp、Glu和Gly浓度降低，GABA浓度升高（P〈0．05或0．01）；与A组比较，B组T1-3时脑脊液NSE、Asp、Glu和Gly浓度降低，GABA浓度升高（P〈0．05或0．01）。结论血管内热交换降温可减轻犬重型创伤性脑损伤，降温至35℃较31℃效果好。Objective To investigate the effects of endovascular cooling in different degrees on severe traumatic brain injury in dogs.Methods Eighteen dogs of beth sexes, weighing 12-15 kg, were randomly divided into 3 groups （ n = 6 each） ： hypothermia at 31 ℃ group （group A）, hypothermia at 35 ℃ group （group B） and normothermia group （group C）. The model of severe traumatic brain injury was established according to the improved Feeney＇s free-fall method. Six hours of endovascular cooling was performed using an endovascular cooling system in A and B groups. The cerebrospinal fluid （CSF） was collected before traumatic brain injury （To）, and at 24, 48 and 72 h after traumatic brain injury （T1-3） for measurement of the concentrations of neuron-specific enolase （NSE）, S-10013, myelin basic protein （MBP）, aspartate （Asp）, glutamic acid （Glu）, glycine （Gly） and gammaaminobutyric acid （GABA） .Results The concentrations of NSE, S-100β, MBP, Asp, Glu and Gly in CSF were significantly lower at T1-3, while the concentration of GABA in CSF was significantly higher at Ti-3 in groups A and B than in group C （P 〈 0.05 or 0.01）. The concentrations of NSE, Asp, Glu and Gly in CSF were significantly lower at TI-3, while the concentration of GABA in CSF was significantly higher at T1-3 in group B than in group A （ P 〈 0.05 or 0. 01）. conclusion Endovascular cooling can reduce severe traumatic brain injury in dogs, and the efficacy is better when the temperature is reduced to 35 ℃ than that when reduced to 31 ℃.

关 键 词：低温 人工 脑损伤 

分 类 号：R651.15[医药卫生—外科学]