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
2014年
10期
897-901
,共5页
夏建华%刘珍秀%盛睿方%普隽%岑奕%曹霞
夏建華%劉珍秀%盛睿方%普雋%岑奕%曹霞
하건화%류진수%성예방%보준%잠혁%조하
脊髓损伤%氯胺酮%去甲肾上腺素%循环系统
脊髓損傷%氯胺酮%去甲腎上腺素%循環繫統
척수손상%록알동%거갑신상선소%순배계통
Spinal cord injury%Ketamine%Noradrenaline%Circulatory system
目的 研究高位脊髓损伤(spinal cord injury,SCI)后氯胺酮(ketamine,KT)对循环系统紊乱的保护作用. 方法 健康雄性SD大鼠20只,通过抽签将大鼠随机分为单纯SCI组(SCI组)、SCI后给予KT治疗组(SCI+KT组)、对照组(Sham组)和对照给予KT治疗组(Sham+KT组),每组5只.SCI大鼠采用改良Aliens打击法建立脊髓胸4节段损伤动物模型,Sham组仅咬除椎板,未打击脊髓.SCI+KT组和Sham+KT组分别在手术处理后24 h开始给予KT腹腔注射1 mg· kg-1·d-1.观察处理前后1周～6周大鼠平均动脉压(mean arterial pressure,MAP)、心率(heat rate,HR)、24h尿中去甲肾上腺素(noradenaline,NA)的变化,以及6周后大鼠左心室内压变化最大速率(left ventricular internal pressure maximum rate of change,±dp/dtmax)和苏木精-伊红(hematoxylin and eosin,HE)心肌染色的变化. 结果 术后1周SCI组大鼠MAP为(90±4) mmHg(1 mmHg=0.133 kPa),较Sham组明显降低,同时伴有HR增至(518±11)次/min、尿中NA减少、6周后左心室内压最大上升速率(left ventricular internalpressure maximum rising rate,+dp/dmax)增大、心肌纤维化明显(P＜0.05);SCI+KT组较SCI组MAP升高至(106±4) mmHg、HR下降到(459±10)次/min、尿中NA增多、6周后+dp/dtmax减小、心肌纤维化程度明显减轻(P＜0.05). 结论 SCI后使用KT可以改善血流动力学指标,从而改善大鼠心肌收缩力,减轻心肌细胞损伤,而这种作用可能是通过增加机体NA含量实现的.
目的 研究高位脊髓損傷(spinal cord injury,SCI)後氯胺酮(ketamine,KT)對循環繫統紊亂的保護作用. 方法 健康雄性SD大鼠20隻,通過抽籤將大鼠隨機分為單純SCI組(SCI組)、SCI後給予KT治療組(SCI+KT組)、對照組(Sham組)和對照給予KT治療組(Sham+KT組),每組5隻.SCI大鼠採用改良Aliens打擊法建立脊髓胸4節段損傷動物模型,Sham組僅咬除椎闆,未打擊脊髓.SCI+KT組和Sham+KT組分彆在手術處理後24 h開始給予KT腹腔註射1 mg· kg-1·d-1.觀察處理前後1週～6週大鼠平均動脈壓(mean arterial pressure,MAP)、心率(heat rate,HR)、24h尿中去甲腎上腺素(noradenaline,NA)的變化,以及6週後大鼠左心室內壓變化最大速率(left ventricular internal pressure maximum rate of change,±dp/dtmax)和囌木精-伊紅(hematoxylin and eosin,HE)心肌染色的變化. 結果 術後1週SCI組大鼠MAP為(90±4) mmHg(1 mmHg=0.133 kPa),較Sham組明顯降低,同時伴有HR增至(518±11)次/min、尿中NA減少、6週後左心室內壓最大上升速率(left ventricular internalpressure maximum rising rate,+dp/dmax)增大、心肌纖維化明顯(P＜0.05);SCI+KT組較SCI組MAP升高至(106±4) mmHg、HR下降到(459±10)次/min、尿中NA增多、6週後+dp/dtmax減小、心肌纖維化程度明顯減輕(P＜0.05). 結論 SCI後使用KT可以改善血流動力學指標,從而改善大鼠心肌收縮力,減輕心肌細胞損傷,而這種作用可能是通過增加機體NA含量實現的.
목적 연구고위척수손상(spinal cord injury,SCI)후록알동(ketamine,KT)대순배계통문란적보호작용. 방법 건강웅성SD대서20지,통과추첨장대서수궤분위단순SCI조(SCI조)、SCI후급여KT치료조(SCI+KT조)、대조조(Sham조)화대조급여KT치료조(Sham+KT조),매조5지.SCI대서채용개량Aliens타격법건립척수흉4절단손상동물모형,Sham조부교제추판,미타격척수.SCI+KT조화Sham+KT조분별재수술처리후24 h개시급여KT복강주사1 mg· kg-1·d-1.관찰처리전후1주～6주대서평균동맥압(mean arterial pressure,MAP)、심솔(heat rate,HR)、24h뇨중거갑신상선소(noradenaline,NA)적변화,이급6주후대서좌심실내압변화최대속솔(left ventricular internal pressure maximum rate of change,±dp/dtmax)화소목정-이홍(hematoxylin and eosin,HE)심기염색적변화. 결과 술후1주SCI조대서MAP위(90±4) mmHg(1 mmHg=0.133 kPa),교Sham조명현강저,동시반유HR증지(518±11)차/min、뇨중NA감소、6주후좌심실내압최대상승속솔(left ventricular internalpressure maximum rising rate,+dp/dmax)증대、심기섬유화명현(P＜0.05);SCI+KT조교SCI조MAP승고지(106±4) mmHg、HR하강도(459±10)차/min、뇨중NA증다、6주후+dp/dtmax감소、심기섬유화정도명현감경(P＜0.05). 결론 SCI후사용KT가이개선혈류동역학지표,종이개선대서심기수축력,감경심기세포손상,이저충작용가능시통과증가궤체NA함량실현적.
Objective To study the protective effect of ketamine(KT) on circulatory system disorders after high-level spinal cord injury (SCI) in rats.Methods Twenty male 18-week-old SD rats weighing 290 g-310 g were randomly divided into 4 groups (n=5):SCI group,SCI+KT group,Sham group and Sham+KT group.The animals in SCI and SCI+KT groups were subjected to SCI at T4 according to modified Allen's method.The operations for Sham group and Sham+KT group were preformed without stroking spinal cord.Twenty-four hours after the operation,SCI+KT group and Sham+KT group were treated with ketamine 1 mg·kg-1 ·d-1,daily lasting 6 weeks.Mean arterial pressure(MAP),heat rate(HR) and the level of noradenaline(NA) in urine were recorded once a week for 6 weeks.At the end of 6 weeks post operation,left ventricular internal pressure maximum rate of change (-±dp/dtmax) were recorded and myocardial specimen was sampled from left ventricle to study myocardial histology with HE staining.Results In SCI group,the animal's MAP[(90±4) mmHg(1 mmHg=0.133 kPa)] and NA level were significantly lower and HR[(518±11) bpm] were significantly faster starting from 1 week post SCI compared with Sham group.Left ventricular internal pressure maximum rising rate (+dp/dtmax) were significantly increased 6 weeks post SCI.However,in SCI+KT group,the animals' MAP increased to (106±4) mmHg,HR decreased to (459±10) bpm,and +dp/dtmax and NA lever changed significantly (P＜0.05).Ultrastructure Of myocardial tissue presented abnormal changes in SCI groups,but the changes in SCI+KT group were milder.Conclusions High-level spinal cord injury could induce the disorders of circulatory system.Ketamine can increase NA lever and improve hemodynamics and myocardial function after SCI.
