亚低温对蛛网膜下腔出血后迟发血管痉挛时大鼠脑内大血管的保护作用  

Animal study about the hypothermia of protect the rats cerebral artery after delayed ischemic neurological deficits

作　　者：徐翔[1] 刘爱军[1] 

机构地区：[1]唐山工人医院神经外科,063000

出　　处：《中华神经外科杂志》2013年第7期741-745,共5页Chinese Journal of Neurosurgery

摘　　要：目的建立稳定可靠的SAH动物模型后，根据大鼠脑底大血管的病理改变，研究亚低温对于蛛网膜下腔出血后迟发血管痉挛时脑内大血管的保护作用。方法（1）选择成年sD大鼠作为模型动物，采取改良的枕大池二次注血建立蛛网膜下腔出血模型。于二次注血后第5天进行研究，亚低温组用冰袋全身降温治疗另两组维持体温在正常范围。（2）应用激光多普勒（LDF）监测大鼠皮层脑血流的变化以及脑底大血管的病理改变证实血管痉挛的发生。（3）通过光镜、电镜研究对比脑底大血管的大体及超微结构变化，来探求亚低温对于迟发血管痉挛时脑内大血管的保护作用。结果大鼠基底动脉光镜结果发现亚低温及常温组均发生了明显的血管痉挛，表现为血管直径减小、管壁增厚、管腔周长减少、内弹力膜皱褶，同时可见痉挛血管细胞增殖现象明显。测量发现常温组基底动脉直径减少了50．59％，管壁厚度增加了159．27％，管腔内周长减少了62．50％。透射电子显微镜观察：常温组伴有大量内皮细胞的剥离导致内弹力膜的裸露，平滑肌细胞的坏死。亚低温组未见细胞膜破裂，紧密连接尚好，内弹力膜未见裸露，细胞连接未见明显改变，胞质中细胞器结构尚清晰，可见内质网、高尔基氏器、胞饮小泡、微丝及核糖体，细胞间连接未见明显损伤，仍可见缝隙连接。结论亚低温治疗可能在一定程度上减轻或减缓血管壁的病理改变，从而对维持脑供血、减轻因脑缺血造成的神经细胞损害起到积极的作用。Objective To construct the stable and reliable animal model. According to the change of the pathological changes of the basilar artery, to study the affect of applying the hypothermia treatment to the rats after the delayed ischemic nerurologieal deficits （DIND） which were induced by subaraehnoid hemorrhage. Methods 100 rats were divided into 3 groups, hypothermia, normothermia and control respectively. Introduce delayed vasospasm animal model by two stages blood injection. The contrastive study is beginning at the 5＇h day after the second injection. According to the different cortex blood flow among three groups, we compare the pathological change of the basilar artery, which were checked by electronic microscope, to confirm the presence of vasospasm. We discussed the effect of hypothermia to the DIND by the differentia of the pathological changes of the basilar artery. Result Light microscopic examination： Different degrees of cerebral vasospasm were observed in hypothermic and control groups, especially severe in normothermia group （ P 〈 0. 05 ）. The basal artery revealed luminal narrowing, reduction in diameter, increased wall thickness, corrugation of the internal elastic lamina （IEL） , and cellular proliferation were observed in the spastic BA as well. However, the hypothermic group is better than the control group. In control group, the mean diameter of BA was reduced from control levels by 50. 59% ; the increases in wall thickness of BA were 159. 27% ; the mean luminal perimeter reduced by 62. 50% . As far as the wall thickness of BA, obvious difference was seen between the hypothermie and the normothermia group. Transmission electron microscopic examination： The morphological changes in endothelial were most severe and wide spread in normothermia group with some endothelial cells and smooth muscle cells showed evidence of necrotic changes. Detachment of endothelial cells was widespread resulting in large areas of denudation from the IEL. The same pathological changes were also seen in

关 键 词：亚低温 蛛网膜下腔出血 血管痉挛 大鼠 基底动脉 

分 类 号：R743.35[医药卫生—神经病学与精神病学]