颈内动脉局部灌注冷生理盐水对大鼠急性脑梗死的治疗效果  

The efficacy of intra-carotid infusion with cold saline in rats with acute cerebral ischemia

作　　者：宋玮[1] 吴永明[1] 姬仲[1] 冀雅彬[1] 潘速跃[1] 

机构地区：[1]南方医科大学南方医院神经内科,广州市510515

出　　处：《实用医学杂志》2017年第7期1025-1028,共4页The Journal of Practical Medicine

基　　金：国家自然科学基金资助项目(编号:81271521)

摘　　要：目的:探讨颈内动脉灌注冷生理盐水诱导的选择性脑部低温对大鼠的安全性以及对急性脑缺血-再灌注损伤的治疗效果。方法:60只SD大鼠随机分为假手术组、正常灌注组、梗死组、局部低温组、局部常温组、静脉低温组。灌注前后监测脑温、肛温以及各生理指标。再灌注24、48 h进行神经行为学评分;再灌注48 h后检测脑梗死体积及脑含水量。结果:颈内动脉灌注15℃生理盐水可使脑温在10 min时到达33~34℃,停止灌注60 min后回升至灌注前水平。正常大鼠局部灌注冷生理盐水后神经行为学及组织学未见明显异常,脑含水量与假手术组无显著差异(P>0.05)。灌注前后各个时间点生理指标差异无显著性(P>0.05)。局部低温组其梗死体积、脑含水量、神经行为学评分均显著低于梗死组(P<0.05)。而局部常温组及静脉低温组各指标与梗死组比较差异均无统计学意义(P>0.05)。结论:颈内动脉灌注冷生理盐水是一种高效、安全的选择性低温方法,可以显著减少急性脑梗死的梗死体积及脑含水量,促进神经功能恢复。Objective To investigate the safety and therapeutic effect of intra-carotid infusion with cold sa- line in rats with acute focal cerebral ischemia-repeffusion injury. Methods 60 rats were randomly divided into six groups： sham operated group, normal infusion group, stroke group, local hypothermic group, local normothermic group, and systemic infusion group. Brain infarct volume and cerebral water content were analyzed 48 h after ischemia. Neurological deficits were assessed using the mNSS 24 h and 48 h after infarction. Results In the local hypothermic group, brain temperature was reduced to 33 to 34℃ within 5 to 10 minutes, and this significantly low temperature maintained to nearly 60 minutes after infusion continued. Physiological variables were not significantly different among each time point （P 〉 0.05）. No significant morphological abnormality was found in brain sections stained with TTC and HE. Animals receiving local cold infusion significantly decreased infarct volume and brain water content compared to stroke group （P 〈 0.05）. Both 24 h and 48 h mNSS in local hypothermic group was significantly lower than those in other groups （P 〈 0.05）. Conclusions Intra-carotid infusion with cold saline can quickly and effectively reduce brain temperature and is a relatively safe cooling method. Local hypothermia significantly reduced brain infarct volume, decreased brain water content and improved neurological functional outcomes after brain ischemia.

关 键 词：脑梗死 选择性脑低温 局部灌注 神经保护 

分 类 号：R743.3[医药卫生—神经病学与精神病学]