CAJ | 학술논문

目的利用犬深低温停循环(DHCA)动物模型,研究左旋精氨酸(L-arg)预处理对DHCA不同时期犬脑氧代谢及超微结构的影响.方法健康成年杂种犬15只,分为3组,即对照组;L-arg预处理组:停循环前60min给予L-arg100mg/kg预处理;联合处理组:停循环前60min给予L-arg100mg/kg、7-硝基吲唑(7-Ni)25mg/kg联合处理,每组各5只.按临床方法建立体外循环转流降温至鼻咽部温18℃停循环,90min后恢复循环复温.分别于停循环前30min、停循环时(0min)、停循环45min、停循环90min、复温再灌注60min抽取颈静脉、颈动脉血测颈静脉血氧饱和度(SjvO2)、一氧化氮(NO).实验犬处死时颈动脉灌注4%多聚甲醛固定,取脑皮质、海马行透射电镜观察脑组织超微结构.结果 L-arg预处理和联合处理均可增加血浆N0含量、提高DHCA期SjvO2,改善脑氧代谢,减轻脑超微结构损害.停循环前血浆NO与停循环后SjvO2呈正相关(r=0.679,P=0.005).结论 DHCA前给予L-arg预处理有较好的脑保护效果.
목적 이용견심저온정순배(DHCA)동물모형,연구좌선정안산(L-arg)예처리대DHCA불동시기견뇌양대사급초미결구적영향.방법 건강성년잡충견15지,분위3조,즉대조조;L-arg예처리조:정순배전60min급여L-arg100mg/kg예처리;연합처리조:정순배전60min급여L-arg100mg/kg、7-초기신서(7-Ni)25mg/kg연합처리,매조각5지.안림상방법건입체외순배전류강온지비인부온18℃정순배,90min후회복순배복온.분별우정순배전30min、정순배시(0min)、정순배45min、정순배90min、복온재관주60min추취경정맥、경동맥혈측경정맥혈양포화도(SjvO2)、일양화담(NO).실험견처사시경동맥관주4%다취갑철고정,취뇌피질、해마행투사전경관찰뇌조직초미결구.결과 L-arg예처리화연합처리균가증가혈장N0함량、제고DHCA기SjvO2,개선뇌양대사,감경뇌초미결구손해.정순배전혈장NO여정순배후SjvO2정정상관(r=0.679,P=0.005).결론 DHCA전급여L-arg예처리유교호적뇌보호효과.
Objective To investigate the effect of L-arginine (L-arg) on cerebral oxygen metabolism and ultrastructure during deep hypothermic circulatory arrest (DHCA) in experimental dogs. Methods Fifteen healthy adult mongrel dogs with both sexes, weighing (14.7±2.4)kg, were randomly divided into three groups (n=5): sham treated group, L-arg pretreated group (100mg/kg L-arg was given 60min before circulation arrest), L-arg and 7-Ni combined treated group (100mg/kg L-arg and 25mg/kg 7-Ni were given 60min before circulation arrest). Extracorporeal circulatory was established routinely, and DHCA commenced when the nasopharyngeal temperature was reduced to 18℃, then reperfusion began after 90min of DHCA. SjvO2, NO in plasma were measured 30min before DHCA and 0,45,90min after DHCA commencement and 60min after rewarming. The ultrastructural changes of cortex and hippocampal gyrus were also been observed with transmission electron microscope after the dogs were executed. Results Compared with sham-treated group, L-arg pretreatment combined with 7-Ni or not increased NO content in plasma, SjvO2 during DHCA, improved cerebral oxygen metabolism and reduced brain ultrastructural injury. There was a positive correlation between NO conten in plasma before arrest and SjvO2 after arrest (r=0.679,P=0.005). Conclusion L-arg pretreatment has cerebral protective effects and can improve cerebral oxygen metabolism during DHCA.