国际麻醉学与复苏杂志
國際痳醉學與複囌雜誌
국제마취학여복소잡지
INTERNATIONAL JOURNAL OF ANESTHESIOLOGY AND RESUSCITATION
2011年
6期
647-649
,共3页
郭文义%贺萍%薛立超%武志平%梁李娟%赵嘉训
郭文義%賀萍%薛立超%武誌平%樑李娟%趙嘉訓
곽문의%하평%설립초%무지평%량리연%조가훈
脑缺血/再灌注损伤%甘露醇%小鼠
腦缺血/再灌註損傷%甘露醇%小鼠
뇌결혈/재관주손상%감로순%소서
Cerebral ischemia/reperfusion injury%Mannitol%Mice
目的 探索脑缺血/再灌注损伤(ischemia/reperfusion injury,I/RI)后甘露醇干预的最佳时机.方法 健康昆明小鼠36只,制备I/RI模型后,按随机数字表法分为6组(每组6只):假手术组(A组)、对照组即I/RI组(B组)和再灌注即刻、30 min、1、1.5 h甘露醇干预组(分别为C、D、E和F组).再灌注24 h后取脑组织,对各组海马CA1区细胞的病理形态学变化、存活细胞数和变性细胞率作出检测.结果 脑缺血/再灌注(ischemia/reperfusion,I/R)即刻甘露醇干预组锥体细胞大多保持正常形态,细胞结构完好,细胞间质无水肿表现;存活细胞数为(22.0±1.1)个/100 μm,与假手术组(23.0±0.9)个/100 μm比较差异无统计学意义(P>0.05);变性细胞率(8.17%)较对照组(40.17%)明显减少(P<0.05),与假手术组(7.33%)比较差异无统计学意义(P>0.05).再灌注30 min以上甘露醇再干预,神经元损伤不能改善.结论 脑I/R早期血压梯度建立后及时给予甘露醇建立反相的渗透压梯度,可以有效防止细胞水肿的形成,并能阻断由此引发的不可逆细胞损害.研究发现恢复灌注30 min以上再给予甘露醇基本无效.
目的 探索腦缺血/再灌註損傷(ischemia/reperfusion injury,I/RI)後甘露醇榦預的最佳時機.方法 健康昆明小鼠36隻,製備I/RI模型後,按隨機數字錶法分為6組(每組6隻):假手術組(A組)、對照組即I/RI組(B組)和再灌註即刻、30 min、1、1.5 h甘露醇榦預組(分彆為C、D、E和F組).再灌註24 h後取腦組織,對各組海馬CA1區細胞的病理形態學變化、存活細胞數和變性細胞率作齣檢測.結果 腦缺血/再灌註(ischemia/reperfusion,I/R)即刻甘露醇榦預組錐體細胞大多保持正常形態,細胞結構完好,細胞間質無水腫錶現;存活細胞數為(22.0±1.1)箇/100 μm,與假手術組(23.0±0.9)箇/100 μm比較差異無統計學意義(P>0.05);變性細胞率(8.17%)較對照組(40.17%)明顯減少(P<0.05),與假手術組(7.33%)比較差異無統計學意義(P>0.05).再灌註30 min以上甘露醇再榦預,神經元損傷不能改善.結論 腦I/R早期血壓梯度建立後及時給予甘露醇建立反相的滲透壓梯度,可以有效防止細胞水腫的形成,併能阻斷由此引髮的不可逆細胞損害.研究髮現恢複灌註30 min以上再給予甘露醇基本無效.
목적 탐색뇌결혈/재관주손상(ischemia/reperfusion injury,I/RI)후감로순간예적최가시궤.방법 건강곤명소서36지,제비I/RI모형후,안수궤수자표법분위6조(매조6지):가수술조(A조)、대조조즉I/RI조(B조)화재관주즉각、30 min、1、1.5 h감로순간예조(분별위C、D、E화F조).재관주24 h후취뇌조직,대각조해마CA1구세포적병리형태학변화、존활세포수화변성세포솔작출검측.결과 뇌결혈/재관주(ischemia/reperfusion,I/R)즉각감로순간예조추체세포대다보지정상형태,세포결구완호,세포간질무수종표현;존활세포수위(22.0±1.1)개/100 μm,여가수술조(23.0±0.9)개/100 μm비교차이무통계학의의(P>0.05);변성세포솔(8.17%)교대조조(40.17%)명현감소(P<0.05),여가수술조(7.33%)비교차이무통계학의의(P>0.05).재관주30 min이상감로순재간예,신경원손상불능개선.결론 뇌I/R조기혈압제도건립후급시급여감로순건립반상적삼투압제도,가이유효방지세포수종적형성,병능조단유차인발적불가역세포손해.연구발현회복관주30 min이상재급여감로순기본무효.
Objective To investigate the optimal timing of mannitol intervention in cerebral ischemia-reperfusion injury.Methods Thirty-six mice were randomly divided into six groups (n=6):The sham operation group (group A),the control group (ischemia-reperfusion injury group,group B),aud the mannitol intervention group at the time of 0 min,30 min,1 h and 1.5 h after reperfusion (group C,D,E,F).Taken the brain twenty-four hours after ischemia-reperfusion injury.Morphological changes,viability and degradation of cells in the area of CA1 of hippocampus were studied in each group.Results In the experimental group with mannitol intervention immediately after reperfusion,most hippocampal pyramidal cells remained normal morphology with intact structures and no intercellular edema was observed.The amount of viable cells was (22.0±1.1) per 100 μm which was not significantly different from that of the sham operation group (23.0±0.9).The incidence of cell degradation was 8.17%,which was significantly lower than that of the control group (40.17%,P<0.05).The cell degradation difference between the experimental group and sham operation group(7.33%) was not significant(P>0.05).Mannitol intervention beginning over 30 min after reperfusion failed to alleviate neuron injury.Conclusion After the establishment of blood pressure gradient,inverted osmotic pressure gradient by means of prompt mannitol intervention at the early stage of cerebral ischemia-reperfusion can effectively prevent the formation of intracellular edema and avoid the consequent irreversible cellular injury.Mannitol intervention beginning over 30 min after reperfusion was proved ineffective.