实验性脑梗死的亚低温治疗时间窗——亚低温开始时间对脑梗死体积的影响  

Therapeutic window of mild hypothermia for cerebral middle artery occlusion:the effect of onset of mild hypothermia on infarction volume

作　　者：李承晏[1] 李涛[1] 梅志忠[1] 喻文莉[1] 余绍祖[1] 

机构地区：[1]武汉大学人民医院神经科,湖北武昌430060

出　　处：《中国危重病急救医学》2001年第8期485-487,共3页Chinese Critical Care Medicine

基　　金：湖北省科委科研基金资助项目 ( No.95 2 P190 2 )

摘　　要：目的 :确定脑梗死亚低温治疗的时间窗。方法 :12 0只 SD鼠随机分为对照组和实验组 ,每组 60只 ;每组再分为大脑中动脉阻塞 ( MCAO)后 2、4、6、8、10和 12小时亚组 ,每亚组 10只。所有大鼠 MCAO后 2小时开始再灌注。监测心率 ( HR)、呼吸 ( R)、血氧饱和度 ( SO2 )、肛温 ( T)和血压 ( BP) ,实验组在 MCAO后不同时间将肛温控制在 ( 3 4 .0± 1.0 )℃。 2 4小时后处死动物 ,每亚组各取 5只测定脑组织含水量 ,另 5只测定梗死灶体积并作病理检查。结果 :所有 SD鼠 MCAO后 BP均较阻塞前明显升高 ( P<0 .0 1) ,但对照组与实验组间无明显差异 ( P>0 .0 5 ) ;实验组 MCAO后 2、4、6小时的 SD鼠脑组织含水量明显降低 ( P<0 .0 5 ) ,但 MCAO后 8、10小时组与对照组无统计学差异 ( P>0 .0 5 )。MCAO后 2、4、6、8、10小时开始亚低温组的脑梗死体积均明显小于对照组 ( P均 <0 .0 1) ;但 MCAO后 12小时开始亚低温不能减少梗死体积 ( P>0 .0 5 )。结论 :MCAO后 2小时开始再灌注 ,10小时后开始亚低温仍能减少梗死体积 ,8小时后开始亚低温能减少脑组织含水量 ;但 12小时后开始亚低温并不能减少梗死体积 ,10小时后开始亚低温不能减少脑组织含水量。Objective:To investigate the therapeutic window of mild hypothermia on cerebral infarction.Methods:One hundred and twenty SD rats were randomly divided into control group and experiment group,each group were further divided into 2,4,6,8,10 and 12 hours subgroups.All rats were reperfused after cerebral middle artery occlusion (MCAO) for two hours.The heart rate,respiratory rate,blood pressure,oxygen saturation and rectal temperature were monitored.The rectal temperature of the experiment group was controlled at (34.0±1.0)℃ at different intervals after MCAO.The rats were sacrificed after MCAO,and the infarction volume,brain water content and histological changes were observed.Results:The blood pressure of all animals was higher after MCAO than that prior to MCAO (P<0.01),but no marked difference was found between the control group and experimental group (P>0.05).The brain water content was low in 2,4,6 hours mild hypothermia groups (P<0.05),but no significant difference was found between the control group and 8 or 10 hours groups (P>0.05).The infarction volume decreased in 2,4,6,8,10 hours mild hypothermia groups(P<0.05),but no difference was found between the control group and 12 hours group (P>0.05).Conclusions:With reperfusion after MCAO for two hours,mild hypothermia can reduce infarction volume beginning at 10 hours and decrease brain water content beginning at eight hours after MCAO.The infarction volume cannot be reduced if mild hypothermia begins at 12 hours,and brain water content cannot be decreased if mild hypothermia begins at eight hours after MCAO.

关 键 词：脑梗死 实验性 亚低温 治疗时间窗 

分 类 号：R743.33[医药卫生—神经病学与精神病学]