Nishio Shinsaku, Kawauchi Masamitsu, Tamiya Takashi, Ohmoto Takashi
Department of Neurological Surgery, Okayama University Medical School, Japan.
Neurol Res. 2002 Sep;24(6):621-6. doi: 10.1179/016164102101200465.
We examined the effects of mild to moderate hypothermia and the influence of rewarming on electrophysiological function using somatosensory evoked potentials (SEPs) in transient focal ischemia in the brain. Nineteen cats underwent 60 min of left middle cerebral artery occlusion under normothermic (36 degrees-37 degrees C, n = 6) or hypothermic (30 degrees -31 degrees C, n = 13) conditions followed by 300 min of reperfusion with slow (120 min, n = 6) or rapid (30 min, n = 7) rewarming. Whole-body hypothermia was induced during ischemia and the first 180 min of reperfusion. SEPs and regional cerebral blood flow were measured before and during ischemia and during reperfusion. The specific gravity of gray and white matter was examined as the indicator of edema. During rewarming, SEP amplitudes recovered gradually. After rewarming, SEPs in the normothermic and rapid rewarming groups remained depressed (20%-40% of pre-occlusion values); however, recovery of SEPs was significantly enhanced in the slow rewarming group (p < 0.05). Hypothermia followed by slow rewarming reduced edema in gray and white matter. Rapid rewarming did not reduce edema in the white matter. The recovery of SEPs correlated with the extent of brain edema in transient focal ischemia. Rapid rewarming reduced the protective effect of hypothermia.
我们利用体感诱发电位(SEP)研究了轻至中度低温以及复温对脑短暂局灶性缺血时电生理功能的影响。19只猫在常温(36℃-37℃,n = 6)或低温(30℃-31℃,n = 13)条件下进行60分钟的左侧大脑中动脉闭塞,随后分别以缓慢(120分钟,n = 6)或快速(30分钟,n = 7)复温的方式进行300分钟的再灌注。在缺血期间以及再灌注的前180分钟诱导全身低温。在缺血前、缺血期间以及再灌注期间测量SEP和局部脑血流量。检测灰质和白质的比重作为水肿指标。在复温过程中,SEP波幅逐渐恢复。复温后,常温组和快速复温组的SEP仍处于抑制状态(为闭塞前值的20%-40%);然而,缓慢复温组SEP的恢复明显增强(p < 0.05)。低温后缓慢复温可减轻灰质和白质的水肿。快速复温不能减轻白质水肿。在短暂局灶性缺血中,SEP的恢复与脑水肿程度相关。快速复温降低了低温的保护作用。