利多卡因两种给药途径对兔蛛网膜下腔出血的脑保护作用

Comparison of Two Methods of Lidocaine Administrating for Neuroprotection in Rabbit Model of Subarachnoid Hemorrhage

目的比较利多卡因两种给药途径对蛛网膜下腔出血(SAH)的脑保护作用。方法 40只新西兰大白兔随机分为假手术(sham)组、SAH模型组(SAH组)、利多卡因静脉治疗组(L1组)及利多卡因枕大池治疗组(L2组),每组各10只。麻醉下采用自体动脉血注入枕大池制备SAH模型,sham组注入等量生理盐水(NS);30min后sham组、SAH组及L1组的动物,再次从枕大池注入0.3mL NS,L1组同时静脉给予0.3mL 2%利多卡因治疗,L2组从枕大池注入0.3mL 2%利多卡因治疗。所有动物72h后处死。分别于造模型前、治疗后72h采用ELISA法检测血清白介素-6(IL-6)水平;72h后取脑基底动脉以及海马组织行常规HE染色及C-fos免疫组化染色,测定基底动脉腔面积(AA)和直径(AD)、海马正常神经元密度(NNDHP)、C-fos阳性细胞数目(CCPHP)。结果各组动物造模前血清IL-6水平差异均无统计学意义(P>0.05),治疗后72h各组IL-6水平均较术前高(P<0.05),SAH及L1组高于sham组和L2组(P<0.05)。SAH及L1组基底动脉的AA、AD及海马NNDHP比假手术sham组和L2组减少(P<0.05),而SAH及L1组海马CCPHP比sham组和L2组增多(P<0.05)。结论同剂量利多卡因经枕大池注入比静脉注入对兔蛛网膜下腔出血的脑保护效果好。

Objective To compare the neuroprotection effect of two methods of Lidocaine administration in rabbit model of subarachnoid hemorrhage. Methods Forty New Zealand white rabbits were randomly divided into sham group, subarachnoid hemorrhage group （SAH）, Lidocaine intravenous injection group （L1）, and Lidocaine intracisternal administration group （L2）. The rabbits were given general anaesthesia, then 1.5 mL autologous nonheparinized arterial blood was injected into cisterna magna to establish SAH model, while 1.5 mL saline was used in sham group. Thirty minutes later, the rabbits in L1 and L2 group respectively received 0.3 mL 2% Lidocaine administration of intravenously and intracisternally injection. All animals were sacrificed at 72 h after SAH. The samples of basilar artery and hippocampus tissue were processed for morphometric analysis. At pre-operation and 72 h after SAH, the level of interleukin-6 （IL-6） in serum was measured. HE staining and C fos immunohistochemical staining were performed in L1 and L2 groups. Artery area and artery diameter of basal arteries, normal neuron density and C-fos positive cell in hippocampus were measured at 72 h after SAH. Results The baseline level of IL-6 was not significant different in four groups （P〉0.05）. The level of IL-6 at 72 h after SAH was significantly higher than that at pre-operation in SAH, L1 and L2 groups （P〈0.05）, while the level of IL-6 in SAH and L1 group was higher than that in L2 group （P〈0.05）. Compared to sham and L2 group, the cross-section area and diameter of basal artery were smaller in SAH and L1 group, while the normal neuron density of hippocampus was less （P〈0.05）. [WTHZ]Conclusion Intracisternal administration of Lidocaine could provide neuroprotection in rabbit model of subarachnoid hemorrhage.