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目的探讨亚低温治疗蛛网膜下腔出血伴迟发性脑血管痉挛大鼠对脑代谢的影响。方法将40只成年SD大鼠随机分为对照组、常温组和亚低温治疗组,每组10只。另用4只观察蛛网膜下腔的血液分布,6只备用。采用两次枕大池注血制作模型。亚低温组用冰袋全身降温,维持体温在31~33℃;对照组和常温组维持体温在37~38℃。于第2次注血后第5天进行连续检测8 h,检测指标包括脑微透析液中葡萄糖、乳酸、丙酮酸和乳酸/丙酮酸比值(L/P)。结果脑微透析液中葡萄糖水平:常温组(0.44±0.08)mmol/L<亚低温治疗组(0.53±0.03)mmol/L<对照组(0.74±0.06)mmol/L;丙酮酸水平:常温组(20.0±2.4)mmol/L<亚低温治疗组(28.8±6.3)mmol/L<对照组(35.9±7.6)mmol/L;乳酸水平:亚低温治疗组(0.66±0.05)μmol/L<对照组(0.93±0.06)μmol/L<常温组(1.91±0.32)μmol/L;L/P比值:亚低温治疗组(28±12)<对照组(35±10)<常温组(108±26)。在8 h内重复测量的其他指标变化亦呈上述变化趋势。结论蛛网膜下腔出血伴迟发性脑血管痉挛后经亚低温治疗,可通过降低实验动物的脑氧耗量,维持细胞能量代谢以及减轻乳酸堆积等作用,对脑组织起到保护作用。
Objective To investigate the effects of mild hypothermia on brain metabolism in rats with delayed cerebral vasospasm and subarachnoid hemorrhage. Methods Forty adult SD rats were randomly divided into control group, normal temperature group and hypothermia treatment group, with 10 rats in each group. Another 4 to observe the subarachnoid blood distribution, 6 spare. Using two occipital injection of blood production model. In the mild hypothermia group, the whole body temperature was decreased with the ice pack, maintaining body temperature at 31 ~ 33 ℃; while in the control group and normal temperature group, the body temperature was maintained at 37 ~ 38 ℃. On the fifth day after the second injection, blood samples were collected for 8 hours. The detection indexes included glucose, lactate, pyruvate and lactate / pyruvate ratio (L / P) in brain microdialysis solution. Results The levels of glucose in brain microdialysate were (0.44 ± 0.08) mmol / L in hypothermia group (0.53 ± 0.03) mmol / L and 0.74 ± 0.06 mmol / L in hypothermia group (20.0 ± 2.4) mmol / L (28.8 ± 6.3) mmol / L in the group of mild hypothermia (35.9 ± 7.6 mmol / L) and lactate levels (0.66 ± 0.05) μmol / L in the group of mild hypothermia Group (0.93 ± 0.06) μmol / L group (1.91 ± 0.32) μmol / L at normal temperature; L / P ratio: 28 ± 12 in control group (35 ± 10) ). Other indicators of repeated measures within 8 h also showed the above trend. Conclusion Subarachnoid hemorrhage with delayed cerebral vasospasm after mild hypothermia treatment can protect brain tissue by reducing brain oxygen consumption, maintaining cellular energy metabolism and reducing lactic acid accumulation in experimental animals.