深低温停循环间断灌注脑保护液的实验研究

Experimental study of cerebral protection of intermittent cerebroplegia perfusion during deep hypothermic circulatory arrest

目的 研究深低温停循环 (DHCA)间断灌注充氧脑保护液的脑保护效果及机制。方法健康杂种犬 10条 ,A组单纯DHCA 12 0min ,B组DHCA后经双侧颈动脉间断灌注充氧脑保护液。两组动物于不同时相取皮层组织测定其三磷酸腺苷 (ATP)的含量及一氧化氮合酶 (NOS)的活性 ,并作透射电镜 (TE)检查。结果 DHCA 12 0min及恢复循环 45min后 ,B组皮层组织ATP的含量均明显高于A组。A组皮层组织还原型尼克酰胺二磷酸腺苷脱氢酶 (NADPH)阳性神经细胞数量明显多于B组。TE检查显示A组皮层组织线粒体结构破坏严重而B组改变轻微。结论 DHCA间断灌注充氧脑保护液是一种较为理想的脑保护方法。

Objective\ To study the protective effect and the protective mechanism of intermittent oxygenated cerebroplegia perfusion during deep hypothermic circulatory arrest (DHCA). Methods\ Ten mongrel dogs underwent DHCA for 120 min. Five dogs in group B received oxygenated cerebroplegic infusion and 5 dogs in group A did not following DHCA. Cerebral cortex was collected at different time points to determine ATP content, NOS activity and examine the ultrastructure under transmission electron microscopy. Results\ At 120 min of DHCA and at 45 min of reperfusion, the content of ATP in the group B was higher significantly than in the group A. The number of NOS positive neurons in the group A was higher significantly than in the group B. TE examination revealed that the damage of the ultrastructure in the group A was more severe than in the group B. Conclusion\ Intermittent oxygenated cerebroplegia perfusion during DHCA is an optimal cerebral protective method.\;