低温生理盐水与腺苷局部灌注对脊髓缺血损伤的保护作用  

Protection of Spinal Cord Ischemic Injury by Means of Regional Infusion with Hypothermic Normal Saline and Adenosine

作　　者：肖荣冬[1] 谢维泉[1] 翁国星[1] 韩涛[1] 

机构地区：[1]福建省立医院福建省心血管病研究所心外科,福州350001

出　　处：《中国胸心血管外科临床杂志》2001年第1期36-39,共4页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

摘　　要：目的　研究低温生理盐水和腺苷对兔主动脉阻断致脊髓缺血损伤的保护作用。　方法　 30只成年健康新西兰白兔随机分成 3组 ,每组 10只。 A组 :作为缺血对照 ;B组 :用低温生理盐水局部灌注 ;C组 :用低温生理盐水和腺苷局部灌注。通过阻断兔肾动脉水平的腹主动脉 6 0分钟建立兔脊髓缺血损伤模型。观察 3组血流动力学指标、脊髓自由基含量、术后 Tarlov评分和脊髓组织病理学改变。　结果　 3组心率比较均无差异 ,C组血压于阻断腹主动脉2 0分钟时下降 (P<0 .0 5 ) ;A组丙二醛增加 ,超氧化物歧化酶减少 ,而 B组和 C组变化较轻 ;A组大部分发生截瘫 ,B组后肢功能部分恢复 ,C组后肢功能恢复良好 ;病理检查示 A组中央灰质聚集性坏死 ,巨噬细胞浸润 ,尼氏小体消失 ,核仁模糊 ,B组和 C组脊髓结构较完整。　结论　低温生理盐水和腺苷局部灌注具有良好的脊髓保护作用 ,其方法简便。腺苷可减少三磷酸腺苷 (ATP)的耗竭 ,促进其恢复 ,并具有神经保护作用。Objective\ To study the protection of spinal cord ischemic injury by means of regional infusion with hypothermic normal saline and adenosine.\ Methods\ Thirty New Zealand adult rabbits were randomly divided into three groups, group A( n =10): ischemic group, group B( n =10):hypothermic normal saline regional infusion, and group C( n =10):hypothermic normal saline infusion with adenosine. The experimental model was established in rabbits through cross clamping of abdominal aorta inferior to the left renal artery. Hemodynamic data, malondialdehyde and superoxide dismutase of spinal cord were measured in every group. Spinal cord function was assessed by the Tarlov Scale postoperatively and spinal cords were harvested for histologic analysis.\ Results\ There was no marked differences in blood pressure and heart rate among three groups. The malondialdehyde increased and superoxide dismutase decreased in group A, the change was small in group B and group C. Rabbits in group A became paraplegic while group B were partly restored and group C were fully restored to normal. Histologic examination of spinal cords from group B and group C revealed no obvious evidence of ischemic injury, whereas group A showed extensive spinal cord injury with central gray coagulative necrosis, macrophage infiltration, dissolution of Nissl substance.\ Conclusion\ Regional infusion with hypothermic normal saline and adenosine can protect the spinal cord ischemic injury distinctly. Adenosine can not only decrease adenosine triphosphate depletion of ischemic tissue, but also has strong neural protective function.

关 键 词：低温生理盐水 腺苷 脊髓保护 脊髓缺血损伤 

分 类 号：R651.2[医药卫生—外科学]