经腹主动脉灌注低温异丙酚对兔脊髓缺血再灌注损伤的保护作用

The protective effect of hypothermic propofol infusion through the aorta on ischemic spinal cord in rabbit

目的研究低温异丙酚对脊髓缺血再灌注损伤的保护作用。方法40只新西兰白兔,随机分为4组,每组10只。采用阻断兔左肾下腹主动脉30min建立的脊髓缺血模型,经左股动脉灌注液体,A组(对照组)为常温生理盐水组;实验组:B组为低温生理盐水组;C组为低温脂肪乳组;D组为低温异丙酚组(50mg/kg)。4组灌注液体量均为5ml/kg。观察每组兔术中生命体征、再灌注后6,24,48h的神经行为学(Tarlov)评分、再灌注48h后的脊髓组织病理改变和测定脊髓组织中兴奋性氨基酸(谷氨酸和天门冬氨酸)的含量。结果实验组体温均于阻断15min开始下降,组间无差异(P>0.05):除D组阻断15min后平均动脉压开始下降外(P<0.05),A、B、C组均无明显变化;4组动物心率相对平稳;实验组Tarlov评分、脊髓病理学改变及兴奋性氨基酸含量均显著优于A组,其中以D组最佳(P<0.05)。结论经腹主动脉灌注低温液体对脊髓缺血再灌注损伤有保护作用,其中以低温异丙酚的保护作用为明显。

Objective To evaluate the effects of hypothermic propofol infused through the aorta on ischemic spinal cord. Methods 40 New Zealand rabbits were randomly divided into 4 groups. Group A received normal saline and named control group. Group B was designed to receive the hypothermic saline, Group C were infused the hypothermic intralipid, Group D received hypothermic propofol （50mg/kg） regionally .The volume of the four groups were equally 5ml/kg. the infrarenal circum-aortic clamping model（ clamping time was 30 raln）was used in this study,and the liquids were infused through the left femoral.The vital signs, Tarlov Scaleat 6h,24h,48h after reperfusion were record. The spinal cord were harvested at 48h after the reperfusion for histological analysis. And the concentration of excitatory amino acids （ aspartate and glutamate ） were measured. Results The temperature of the test groups （ group B, C, D ） dropped when clamped for 15 mlnutes;but there were no significant difference between the three groups（P 〉 0.05） .The mean blood pressure of group D began to drop at the time when clamped about 15 minutes（P 〈 0.05）, which of the other three groups were stable. The heart rate of the four groups were stable.The Tarlov Scale,histological signs in test groups were better than Which in the group A,the concentration of excitatory amino acids were lower. And group D was the best one. Conclusion Regional hypothermia can protect the isehemie spinal cord, and the protective effect was remarkable when combined with the propofol.