经枕大池注入利多卡因对兔蛛网膜下腔出血的脑保护作用

Neuroprotection of Lidocaine by Injecting into Cisterna Magna in a Rabbit Model of Subarachnoid Hemorrhage

目的探讨经枕大池注入利多卡因可否防止蛛网膜下腔出血(SAH)后脑血管痉挛及其脑组织损伤。方法新西兰大白兔30只随机分为假手术组(sham组)、蛛网膜下腔出血组(SAH组)、利多卡因(lidocaine)治疗组(利多卡因组),每组10只。各组兔均在全麻下行手术操作,SAH组和利多卡因组取自体兔血1.5 mL注入枕大池,sham组注入等量生理盐水(NS);0.5 h后sham组和SAH组经枕大池注入0.1 mL NS,而利多卡因组注入0.1 mL 2%(质量分数)利多卡因。术后72 h处死兔取脑基底动脉及海马组织行病理检查测定基底动脉管腔面积和直径、海马正常神经元密度(NNDHP)、c-fos阳性细胞数目(CCPHP);测定术前和术后72 h的兔血清白介素-6(IL-6)水平。结果各组兔术前血清IL-6水平无显著差别(P>0.05),术后72 h血清IL-6水平各组均较术前增高(均P<0.05),SAH组高于sham组和利多卡因组(P<0.05)。SAH组基底动脉管腔面积和直径以及NNDHP比sham组和利多卡因组减少(P<0.05),SAH组海马CCPHP比sham组和利多卡因组增多(P<0.05)。结论经枕大池注入利多卡因可减轻兔SAH后脑血管痉挛以及海马组织细胞损伤。

Objective To investigate the prevention effect on cerebral vasospasm and hippoeampus tissue damage by intracisternal delivery of lidocaine in rabbit model of subarachnoid hemorrhage. Methods Thirty New Zealand white rabbits were randomly allocated to the sham group, subarachnoid hemorrhage group （SAH）, and lidocaine therapy group（n = 10, respectively）. All animals underwent operation under general anaesthesia. 1.5 mL autologous nonheparinized arterial blood was injected into cisterna magna in the SAH group and lidocaine group, and 1.5 mL saline into cisterna magna in the sham group respectively. Thirty minutes after SAH, 0.1 mL saline was injected into cisterna magna in the sham group and SAH group, and 0. 1 mL 2% lidocaine into cisterna magna in the lidocaine group, respectively. 72 hours later, all animals were deeply anesthetized and killed by perfusion-fixation. Their basilar arteries and the hippocampus tissue were processed for morphometric analysis. The level of interleukin-6 （IL-6） in serum was measured by ELISA pre-operation and at 72 hours after SAH. Results The baseline level of IL-6 was not significantly different in three groups （P〉0.05）. But the level of IL- 6 in the SAH group was higher than that of the other groups （P〈0.05） at 72 hours after SAH. As compared to the baseline, the level of IL-6 was significantly higher in three groups at 72 hours after SAH （P（0.05）. The cross-section areas and diameter of basal arteries, the normal neuron density of the hippocampus were smaller in SAH group than that of the other two groups （P〈0.05）. The cells of expressing c-fos in the hippocampus tissue were more in SAH group than that of the other groups （P〈 0.05）. Conelusions The study indicated＇that intracisternal administration of lidocaine could prevent the cerebral vasospasm and hippocampus tissue damage in a rabbit model of subarachnoid hemorrhage.