CAJ | 학술논문

目的比较腹主动脉不同药物灌注容量对兔局部灌注药物保护缺血脊髓模型的影响.方法采用肾下腹主动脉阻断法建立兔脊髓缺血再灌注损伤模型,缺血期间,V1.5、V3和V6组分别向阻断的腹主动脉段内灌注生理盐水1.5、3.0或6.0 ml/kg,V0组仅阻断不灌药.比较各组阻断部位远端腹主动脉平均压(MAP)、后肢运动功能及脊髓病理学变化.结果 V6、V3、V1.5和V0组缺血期间MAP分别为(49.4±4.5)、(41.0±5.5)、(22.5±1.7)和(17.9±2.6) mmHg(1 mmHg =0.133 kPa),V6和V3组显著高于V0组(P＜0.05);缺血期间与再灌注初期10 min MAP的差值分别为(32.3±9.4)、(44.9±8.9)、(61.8±4.5)和(62.5±6.3)mmHg,V6和V3组显著低于V0组(P＜0.05).V6组所有时点神经行为学评分和再灌注48 h脊髓前角正常运动神经元计数[10 (5.0～12.0)个]均显著高于V0组[0(0～4.5)个](P＜0.05);其余各组与V0组差异无统计学意义(P＞0.05).结论缺血期间以3.0 ml/kg及以下容量向阻断的腹主动脉段内灌注药物,可保证脊髓损伤模型的稳定性,尤以1.5 ml/kg最为可靠.
목적 비교복주동맥불동약물관주용량대토국부관주약물보호결혈척수모형적영향.방법 채용신하복주동맥조단법건립토척수결혈재관주손상모형,결혈기간,V1.5、V3화V6조분별향조단적복주동맥단내관주생리염수1.5、3.0혹6.0 ml/kg,V0조부조단불관약.비교각조조단부위원단복주동맥평균압(MAP)、후지운동공능급척수병이학변화.결과 V6、V3、V1.5화V0조결혈기간MAP분별위(49.4±4.5)、(41.0±5.5)、(22.5±1.7)화(17.9±2.6) mmHg(1 mmHg =0.133 kPa),V6화V3조현저고우V0조(P＜0.05);결혈기간여재관주초기10 min MAP적차치분별위(32.3±9.4)、(44.9±8.9)、(61.8±4.5)화(62.5±6.3)mmHg,V6화V3조현저저우V0조(P＜0.05).V6조소유시점신경행위학평분화재관주48 h척수전각정상운동신경원계수[10 (5.0～12.0)개]균현저고우V0조[0(0～4.5)개](P＜0.05);기여각조여V0조차이무통계학의의(P＞0.05).결론 결혈기간이3.0 ml/kg급이하용량향조단적복주동맥단내관주약물,가보증척수손상모형적은정성,우이1.5 ml/kg최위가고.
Objective To compare the effects of different drug volume on the model for regional aorta-infused drug protection against spinal cord ischemia-reperfusion injury in rabbits.Methods Spinal cord ischemia model was induced in New Zealand white rabbits by infrarenal abdominal aorta occlusion with a balloon catheter for 30 min.Another polycarbonate catheter was inserted into the abdominal aorta with the tip close to the site of occlusion via the femoral artery.During the ischemic period,nothing (V0 group) or different volume (1.5,3.0 or 6.0 ml/kg) of normal saline containing methylene blue (V1.5,V3 and V6 groups) was consecutively infused into the occluded aortic segments via the polycarbonate catheter at different rate of 3.0,6.0,or 12.0 ml/(kg·h).The bilateral common iliac arteries were clamped simultaneouly to prevent drug solution leakage.Thirty min later,blood flow was regained for reperfusion.The change of mean aortic pressure distal to the occluded site was measured throughout the operation.Neurological function was assessed according to the modified Tarlov scales at the moment of palinesthesia and 6,24 and 48 h after reperfusion.Lumbar segements of the spinal cord (L4-5) were harvested at 48 h after reperfusion for histopathologic evaluation,and the total number of normal motor neurons in the anterior horn was counted.Results The abdominal aorta was not completely occluded in V6 group.In V3 and V6 groups,the distal aortic pressure during ischemia was higher than in V0 and V1.5 groups with (41.0 ± 5.5) and (49.4 ± 4.5) vs.(17.9±2.6) and (22.5±1.7) mmHg [1 mmHg=0.133kPa,P＜0.05],while the difference value between ischemia and the first 10 min of reperfusion was lower than in V0 and V1.5 groups with (44.9±8.9)and (32.3±9.4) vs.(62.5±6.3) and (61.8±4.5) mmHg (P＜0.05).Tarlovscores were higher in V6 group than in V0 group at all intervals (P ＜ 0.05).The number of normal motor neurons was greater in V6 group than in V0 group with 10 (5.0-12.0) vs.0 (0-4.5) (P＜0.05).There was no significant difference between other groups and V0 group (P ＞ 0.05).Conclusion Drug volume lower than 3 ml/kg can ensure the model stability of spinal cord injury when infused into the occluded aortic segments during the ischemic period.The optimal volume was 1.5 ml/kg.