颈动脉冷盐水灌注对低温性心脏骤停复苏犬模型的神经保护作用

Neuroprotective effect of intracarotid cold saline infusion following cardiopulmonary resuscitation in a hypothermic cardiac arrest canine model

目的评价颈动脉冷盐水灌注(ICSI)对严重低体温所致心脏骤停犬心肺复苏后脑组织功能的保护作用。方法对10只低体温致心脏骤停比格犬进行心肺复苏,待自主循环恢复(ROSC)后随机分为对照组和实验组,每组5只。对照组接受常规温水浴复温,实验组在温水浴复温基础上进行ICSI,使脑部温度低于36℃并维持6h。ROSC 24h后记录两组神经功能受损评分(NDS)、血清脑组织损伤生物标志物s100β蛋白水平、脑组织含水量和组织病理学变化。结果实验组血清s100β蛋白水平(119.83±42.93pg/ml vs.329.82±190.39pg/ml,P<0.05)和脑组织含水量(79.43%±0.72%vs.80.79%±1.06%,P<0.05)明显低于对照组。对照组脑海马组织锥体细胞损伤更重。两组间NDS评分差异无统计学意义。结论 ICSI可减少低体温所致心脏骤停犬s100β的产生,减轻脑组织病理损伤。

Objective To evaluate the effect of intracarotid cold saline infusion（ICSI） on neurological outcomes in canines with cardiac arrest（CA） introduced by severe hypothermia. Methods Restoration of spontaneous circulation（ROSC） after hypothermic CA was induced in 10 Beagle dogs. These 10 dogs were randomly divided into 2 groups（5 each）. Dogs in control group were rewarmed using warn water bath, and dogs in experimental group received the bath rewarming plus ICSI for 6 hours to maintain the brain temperature 〈36℃. In both groups, the Neurologic Disability Scores（NDS） were recorded at 24 h after the ROSC, and their brains were removed for pathologic analysis using hematoxylin and eosin stain. The brain water content and s100βof serum level were also measured. Results The water content（79.43%±0.72% vs. 80.79%±1.06%, P〈0.05） and serum level of s100β（119.83±42.93 pg/ml vs. 329.82±190.39 pg/ml, P〈0.05） were significantly lower in experimental group than in the control group. Control group presented obvious pathological damage of the hippocampal pyramidal cells. There was no significant difference in NDS between the two groups. Conclusion ICSI could reduce the production of s100β and pathological brain damage in postarrest hypothermic canines.