常温体外循环对脑组织一氧化氮及其合酶的影响

The Effect of Nitric Oxide in Brain Injury During Normothermic Extracorporeal Circulation

目的探讨常温体外循环对脑组织损害及与一氧化氮(NO)的关系。方法将16只羊随机分为低温组及常温组(每组8只),建立体外循环,心脏采用常、低温含血停搏液灌注,低温组血流降温至脑温26℃,常温组保持体温37℃,于转流前、转流100min及主动脉开放45min取脑皮质、心肌组织检测NO,一氧化氮合酶(NOS)和MDA。结果常、低温含血停搏液灌注对心肌有良好的保护作用。常温组的脑组织NO,MDA均明显升高。结论常温体外循环不能有效保护脑组织,温度是关键因素,而NO的升高是主要原因。

Objective To investigate the relation between brain injury and nitric oxide during normothermic cardiopulmonary bypass（ CPB ）. Methods Sixteen sheep were randomly divided into two groups. After cardiopulmonary bypass was established in the group of normothermia137℃ ） and hypothermia（26℃ in brain ） , hearts were arrested by blood cardioplegic solution of normothermia and hypothermia. The level of NO, nitric oxide synthase （ NOS ） and Malondialdehyde（MDA） in the cerebral cortex and cardiac tissue was detected before CPB,100min after CPB and 45 min after open of the aorta respectively. Results Hearts were protected by blood cardioplegic solution of normothermia and hypothermia. NO and MDA level of the cerebral cortex was evidently increased during the normothermic CPB and related with the degree of brain injury. Conclusion Perfusion injury of brain will be aggravated under normothermic CPB ,temperature is important,but the increase of NO level is the primary cause.