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目的:评价头部重点低温(SHC)能否减轻神经元的再灌流损伤和改善轻伤脑神经元的转归。方法:采用“四血管”模式造成完全性脑缺血30分钟,然后将168只新西兰兔随机分为3组,Ⅰ组为未缺血对照组;其余两组动物的3个亚组在缺血后分别再灌流30、180和360分钟;Ⅱ组为常温再灌流组;Ⅲ组为SHC治疗组(28℃)。检测了脑组织中21项内源性伤害因子的变化,并采用计算机图象分析技术,将神经元区分为A(正常)、B(轻伤)等四类。结果:与Ⅰ组相比,Ⅱ组A类神经元所占百分比在再灌流时进行性下降,B类增多(均P<0.01);与Ⅱ组相比,Ⅲ组A类神经元进行性增多,B类也增多;Ⅱ组与A类神经元改变相关的内源性伤害因子是VIP,β-EP,PGl_2,T_3,T_4和Na~+,K~+-ATPase;B类的是β-EP和TXB_2(P<0.05)。Ⅲ组Ca~(2+),Mg~(2+)-ATPase与A类神经元所占百分比变化相关(P=0.019)。结论:SHC能有效地减轻神经元损伤和复苏轻伤神经元,其主要机理为稳定细胞膜和阻断高代谢状态。
Objective: To evaluate whether focal cryogenic temperature (SHC) can reduce the reperfusion injury of neurons and improve the outcome of neurons in the injured lesion. Methods: Complete cerebral ischemia was induced by “four-vessel” model for 30 minutes. Then 168 New Zealand rabbits were randomly divided into three groups. Group Ⅰ was not ischemic control group. The other three groups were divided into three groups The rats were reperfused 30,180 and 360 minutes after ischemia respectively. Group Ⅱ was normal temperature reperfusion group; Group Ⅲ was SHC treatment group (28 ℃). Twenty-one endogenous injury factors in brain tissue were detected. Four types of neurons were divided into A (normal) and B (minor) by computer image analysis. Results: Compared with group Ⅰ, the percentage of type A neurons in group Ⅱ decreased progressively and increased in group B (all P <0.01). Compared with group Ⅱ, the number of neurons in group Ⅲ increased significantly , B group also increased; Ⅱ group and A neuronal changes related to endogenous injury factors are VIP, β-EP, PGl_2, T_3, T_4 and Na ~ +, K ~ + -ATPase; EP and TXB_2 (P <0.05). The percentage of Ca ~ (2 +) and Mg ~ (2 +) - ATPase in group Ⅲ was related to the change of percentage of neurons in group A (P = 0.019). Conclusion: SHC can effectively alleviate the damage of neurons and the recovery of the injured minor neurons. The main mechanism is to stabilize the cell membrane and block the hypermetabolism.