中华儿科杂志
中華兒科雜誌
중화인과잡지
Chinese Journal of Pediatrics
2001年
1期
11-14
,共4页
低温,人工%丙烯乙二醇类%脑缺氧%脑缺血
低溫,人工%丙烯乙二醇類%腦缺氧%腦缺血
저온,인공%병희을이순류%뇌결양%뇌결혈
目的 探讨亚低温和(或)非氨酯对缺氧缺血(hypoxia-ischemia, HI)脑损伤的保护作用。方法 将HI模型鼠（右颈总动脉结扎后给予8%氧气2 h）随机分为亚低温组（脑温降低4.5℃）：包括亚低温24 h组（n=26）、亚低温72 h组（n=48）、非氨酯组（n=48）、亚低温24 h与非氨酯联合治疗组（n=51）和安慰剂组（n=48）。对照组（n=48 )为假手术动物。监测动物的肛温和脑温。以血浆S-100蛋白（S-100）和肌酸激酶脑型同功酶（CK-BB）水平、病理检查脑损伤分数（BIS）、脑海马神经元死亡率(HDNP)和水迷宫实验结果判断疗效。结果 脑温低于肛温 0.3～0.5℃（r = 0.99, P＜0.01), 亚低温24 h组、亚低温72 h组、联合组动物肛温降低了4～5℃，非氨酯组与安慰剂组肛温维持在36～37℃之间。安慰剂组血浆S-100、CK-BB水平于HI后24～48 h达峰值（分别为1.21～1.24 μg/L和52.9～54.2 IU/ L ), 为对照组的2～3倍，各干预组的S-100和CK-BB水平明显低于安慰剂组（P＜0.01）。HI后72 h、14 d、60 d 亚低温72 h组BIS和HDNP降低程度为58%、85%、87%，联合组为56%、77%、76%，亚低温24 h组为35%、58%、47%，非氨酯组为35%、66%、67%。空间记忆功能依次排列为对照组＞联合组>亚低温72 h组>亚低温24 h组≥非氨酯组>安慰剂组。结论 血生化标志物水平、病理结果分析和水迷宫测试均证实亚低温和(或)非氨酯对新生鼠缺氧缺血性脑损伤具有不同程度的保护作用，亚低温和非氨酯联合干预疗效最佳。
目的 探討亞低溫和(或)非氨酯對缺氧缺血(hypoxia-ischemia, HI)腦損傷的保護作用。方法 將HI模型鼠（右頸總動脈結扎後給予8%氧氣2 h）隨機分為亞低溫組（腦溫降低4.5℃）：包括亞低溫24 h組（n=26）、亞低溫72 h組（n=48）、非氨酯組（n=48）、亞低溫24 h與非氨酯聯閤治療組（n=51）和安慰劑組（n=48）。對照組（n=48 )為假手術動物。鑑測動物的肛溫和腦溫。以血漿S-100蛋白（S-100）和肌痠激酶腦型同功酶（CK-BB）水平、病理檢查腦損傷分數（BIS）、腦海馬神經元死亡率(HDNP)和水迷宮實驗結果判斷療效。結果 腦溫低于肛溫 0.3～0.5℃（r = 0.99, P＜0.01), 亞低溫24 h組、亞低溫72 h組、聯閤組動物肛溫降低瞭4～5℃，非氨酯組與安慰劑組肛溫維持在36～37℃之間。安慰劑組血漿S-100、CK-BB水平于HI後24～48 h達峰值（分彆為1.21～1.24 μg/L和52.9～54.2 IU/ L ), 為對照組的2～3倍，各榦預組的S-100和CK-BB水平明顯低于安慰劑組（P＜0.01）。HI後72 h、14 d、60 d 亞低溫72 h組BIS和HDNP降低程度為58%、85%、87%，聯閤組為56%、77%、76%，亞低溫24 h組為35%、58%、47%，非氨酯組為35%、66%、67%。空間記憶功能依次排列為對照組＞聯閤組>亞低溫72 h組>亞低溫24 h組≥非氨酯組>安慰劑組。結論 血生化標誌物水平、病理結果分析和水迷宮測試均證實亞低溫和(或)非氨酯對新生鼠缺氧缺血性腦損傷具有不同程度的保護作用，亞低溫和非氨酯聯閤榦預療效最佳。
목적 탐토아저온화(혹)비안지대결양결혈(hypoxia-ischemia, HI)뇌손상적보호작용。방법 장HI모형서（우경총동맥결찰후급여8%양기2 h）수궤분위아저온조（뇌온강저4.5℃）：포괄아저온24 h조（n=26）、아저온72 h조（n=48）、비안지조（n=48）、아저온24 h여비안지연합치료조（n=51）화안위제조（n=48）。대조조（n=48 )위가수술동물。감측동물적항온화뇌온。이혈장S-100단백（S-100）화기산격매뇌형동공매（CK-BB）수평、병리검사뇌손상분수（BIS）、뇌해마신경원사망솔(HDNP)화수미궁실험결과판단료효。결과 뇌온저우항온 0.3～0.5℃（r = 0.99, P＜0.01), 아저온24 h조、아저온72 h조、연합조동물항온강저료4～5℃，비안지조여안위제조항온유지재36～37℃지간。안위제조혈장S-100、CK-BB수평우HI후24～48 h체봉치（분별위1.21～1.24 μg/L화52.9～54.2 IU/ L ), 위대조조적2～3배，각간예조적S-100화CK-BB수평명현저우안위제조（P＜0.01）。HI후72 h、14 d、60 d 아저온72 h조BIS화HDNP강저정도위58%、85%、87%，연합조위56%、77%、76%，아저온24 h조위35%、58%、47%，비안지조위35%、66%、67%。공간기억공능의차배렬위대조조＞연합조>아저온72 h조>아저온24 h조≥비안지조>안위제조。결론 혈생화표지물수평、병리결과분석화수미궁측시균증실아저온화(혹)비안지대신생서결양결혈성뇌손상구유불동정도적보호작용，아저온화비안지연합간예료효최가。
Objective To investigate the protective effects of mild hypothermia and/or felbamate on hypoxic-ischemic (HI) brain damage. Methods The HI model rats (subjected to unilateral right carotid artery ligation and given 8% oxygen for 2 h) were allocated to mild hypothermia groups （the brain temperature dropped by 4.5℃) for 24 h course (Hy24，n=26) and 72 h course (Hy72, n=48) , felbamate group (Fbm, n=48), Hy24 combined with Fbm group (HF, n=51) and placebo group (Pla, n=48). The control group (Con, n=42) was shame-operated animals. The rectal temperature (RT) and brain temperature (BT) of experimental animals were monitored. The plasma S-100 and CK-BB levels, brain injury scores (BIS) and percentage of hippocampal dead neurons (HDNP) and the behavioral test of Morris Water Maze were used to assess the protective effects. Results BT was 0.3～0.6℃ which was lower than RT (r=0.99, P＜0.01). RT dropped by 4～5℃in Hy24, Hy72 and HF groups. RT maintained in 36～37℃in Fbm and Pla groups. The peak levels of plasma S-100 and CK-BB in Pla group (1.21～1.24 μg/L and 52.9～54.2 IU/L, respectively) were about 2 to 3 times as high as normal levels between 24 h to 48 h after HI, while the plasma S-100 and CK-BB levels in Hy24，Hy72, Fbm and HF groups were lower than Pla group (P＜0.01). At 72 h, 14d and 60d after HI, the reductions, of BIS and HDNP in Hy72 group were 58%, 85% and 87%, HF group 56%, 77% and 76%, Hy24 group 35%, 58% and 47% and Fbm group 35%, 66% and 67%, respectively. The order of spatial remember function was Con, and HF>Hy72>Hy24≥Fbm>Pla. Conclusions Mild hypothermia and/or felbamate showed different protective effects on brain HI damage as reflected by the changes of the plasma S-100 and CK-BB levels, the results of behavior assessment and histopathological changes. The optimal effect was obtained when hypothermia and felbamate were used simultaneously.
