脑逆灌注减轻脑组织缺血损伤的实验研究

EXPERIMENTAL STUDY ON EFFECT OF RETROGRADE CEREBRAL PERFUSION (RCP) ON REDUCING BRAIN ISCHEMIA DAMAGE IN CATS

脑逆灌注方法是指在脑梗塞患者发病后最短时间内从股动脉引出动脉血经血泵由颈内静脉逆行灌注大脑缺血部位从而缓解缺血程度 ,减轻缺血损伤 ,提高患者预后质量。本研究选用脑组织自由基及炎症因子的变化为指标研究逆灌注减轻脑组织缺血损伤的效果。结果表明逆灌注可在一定程度上减少自由基的产生 ,抑制炎症反应 ,从而减轻和延缓脑的缺血损伤 ,并且灌注效果与灌注参数的选择密切相关。

Objectives: The purpose of this study is to investigate the effect of retrograde cerebral perfusion (RCP) on reducing acute ischemia damage. Methods: Twenty cats were randomly divided into normal group (n=4), control group (n=4), and experimental group. Acute ischemia was made by occlusion of right middle cerebral artery (MCAO). RCP was performed in both control group and experimental group. Arterial blood was harvested through an external pump from the cat′s femoral artery and transported through special designed balloon-tipped catheters placed in the sigmoid sinuses bilaterally into the sigmoid sinuses after. The perfusion pressures were 10mmHg, 15mmHg and 20mmHg respectively. The RCP was initiated 1 hour after MCAO and continued for 1 hour. Plasma and Specimens were obtained from the cerebral tissue to measure SOD, MDA, TNF-α and IL-1. Results: Compared with normal group, all of the four indexes of control group changed significantly (P<0.01). Compared with control group, the indexes of three experimental groups changed in different degree and the third group had very significant change. The SOD level increased and the other indexes decreased. Conclusion: The result showed that RCP might decrease the number of free radical and restrain the inflammation actions in some degree and then reduce or prolong the brain injury, and the RCP effect is related closely to the perfusion pressure.