CAJ | 학술논문

目的通过观察体外循环中采用不同脑保护方法时脑组织中各种炎性细胞因子的变化,探讨脑保护对炎症反应的影响. 方法将18只健康成年杂种犬随机均分为3组:常温体外循环组(normothermic cardiopulmonary bypass,NCPB组),深低温停循环组(deep hypothermic circulatory arrest,DHCA组),深低温停循环+间断选择性顺行性脑灌注组(intermittent selective antegrade cerebral perfusion,ISACP,DHCA+ISACP组).术后检测犬脑组织的含水量,分离并取出海马,制备脑组织匀浆,采用放射免疫法测定白细胞介素1β(IL-1β)和肿瘤坏死因子-a(TNF α)的含量.在透射电子显微镜(TE)下检测海马脑组织的细胞形态学变化.结果DHCA组的IL-1β和TNF-α含量明显高于NCPB组和DHCA+ISACP组(P＜0.01),但NCPB组与DHCA+ISACP组间比较差别无统计学意义(P＞0.05);TNF-α和IL 1β含量与脑水肿的程度呈正相关(r=0.987,0.942;P＜0.01).TE检查显示DHCA组超微结构破坏较严重,而NCPB组和DHCA+ISACP组破坏较轻.结论长时间DHCA会造成脑损伤,DHCA+ISACP有一定的脑保护作用,IL-1β和TNF-a在长时间DHCA中对脑损伤起一定的作用.
목적통과관찰체외순배중채용불동뇌보호방법시뇌조직중각충염성세포인자적변화,탐토뇌보호대염증반응적영향. 방법장18지건강성년잡충견수궤균분위3조:상온체외순배조(normothermic cardiopulmonary bypass,NCPB조),심저온정순배조(deep hypothermic circulatory arrest,DHCA조),심저온정순배+간단선택성순행성뇌관주조(intermittent selective antegrade cerebral perfusion,ISACP,DHCA+ISACP조).술후검측견뇌조직적함수량,분리병취출해마,제비뇌조직균장,채용방사면역법측정백세포개소1β(IL-1β)화종류배사인자-a(TNF α)적함량.재투사전자현미경(TE)하검측해마뇌조직적세포형태학변화.결과DHCA조적IL-1β화TNF-α함량명현고우NCPB조화DHCA+ISACP조(P＜0.01),단NCPB조여DHCA+ISACP조간비교차별무통계학의의(P＞0.05);TNF-α화IL 1β함량여뇌수종적정도정정상관(r=0.987,0.942;P＜0.01).TE검사현시DHCA조초미결구파배교엄중,이NCPB조화DHCA+ISACP조파배교경.결론장시간DHCA회조성뇌손상,DHCA+ISACP유일정적뇌보호작용,IL-1β화TNF-a재장시간DHCA중대뇌손상기일정적작용.