脑休眠灌注唤醒实验研究

Study of Awakening Rabbit Cerebral Dormancy by Perfusion

目的探究兔脑休眠灌注唤醒的机制及其与脑死亡的关系。方法 2010年9月—2014年9月选取健康新西兰白兔36只,按随机数字表法均分6组(A^F组,各6只),按可控性兔全脑缺血实验模型的方法造模,分别比较全脑缺血后的传统复苏及全脑缺血后分别用自配的脑保护液、5%葡萄糖溶液及兔血浆等灌注唤醒大脑的效果;利用MS-2000计算机生物信号记录分析系统全程检测兔的呼吸、心率、血压及脑电;目测实验兔的自主运动、对刺激的反应及脑部水肿等,记录6组兔的生存率。另选取健康新西兰白兔6只,分别提取其抗凝血浆及脑、肝、心、肾等组织浸液,用试管法比较脑、肝、心、肾浸液对血液凝固时间的影响(1~5管)。结果 A、C、D组兔均不能恢复自主呼吸而死亡;B组兔均反射恢复而生存;E组兔1只不能恢复自主呼吸而死亡,其余5只反射恢复而生存;F组兔3只不能恢复自主呼吸而死亡,其余3只反射恢复而生存。6组兔生存率比较,差异有统计学意义(P<0.05);B、E组兔生存率高于A、C、D组(P<0.003 3)。五管血液凝固时间比较,差异有统计学意义(P<0.05)。2、3、4、5管血液凝固时间长于1管(P<0.05);3、4、5管血液凝固时间长于2管(P<0.05);4管血液凝固时间短于3管,5管血液凝固时间长于3管(P<0.05);5管血液凝固时间长于4管(P<0.05)。结论自主研发的脑保护液可有效防止兔大脑停止供血后迅速发生的脑水肿及血液凝固,使脑休眠期延长达60 min,为临床进一步研究提供了参考依据。

Objective To explore the mechanism of awakening rabbit cerebral dormancy by perfusion and its relationship with brain death. Methods The study selected 36 healthy New Zealand white rabbits from september 2010 to 2014. Using random number table method, we divided them into 6 groups （group A - F） with 6 rabbits in each group. Controllable whole brain isehemia experiment models were built, and comparison was made among the awakening effects of conventional resuscitation, selfformulated rabbit cerebral protective fluid, 5% glucose solution and rabbit plasma. By MS - 2000 computer biological signal system, we recorded and analyzed breath, heart rate, blood pressure and electroencephalogram of the rabbits during the whole intervention. Autokinetic movement, response to stimulation and brain edema were observed. The survival rates of the 6 groups were recorded. We selected 6 healthy New Zealand white rabbits and obtained their anticoagulant plasma and tissue extracts of brain, liver, heart and kidney. Using tube method, we compared the influences of brain, liver, heart and kidney extracts on blood coagulation time. Results The rabbits of group A, group C and group D all died because of the irreparability of autonomous respiration ; the rabbits of group B all recovered reflection and survived ; 1 rabbit in group E died because of the irreparability of autonomous respiration, and the rest 5 rabbits recovered reflection and survived; 3 rabbits in group F died due to the irreparability of autonomous respiration, and the rest 3 rabbits recovered reflection and survived. The 6 groups were significantly different in survival rate （ P 〈 0. 05 ） . Group B, group E were higher than group A, group C, group D in survival rate （ P 〈 0. 05 ） . The five tubes of blood were significantly different in coagulation time （ P 〈 0. 05 ） . Tube 2, tube 3, tube 4 and tube 5 had longer blood coagulation time than tube 1 （P 〈 0. 05 ） ; tube 3, tube 4 and tube 5 had longer blood eoagulation time than tube 2 （ P 〈 0. 05 ）, tube 4 had shorter blood coagulation time than tube 3 （ P 〈 0. 05 ）, and tube 5 had longer blood coagulation time than tube 3 （ P 〈 0.05 ） ; tube 5 had longer blood coagulation time than tube 4 （ P 〈 0. 05 ）. Conclusion The self - developed cerebral protective fluid ean effectively prevent cerebral edema and blood coagulation that oceur rapidly after the halt of cerebral blood supply, with the cerebral dormancy prolonging 60 minutes. The study may provide references for further clinical research.