Cakir Omer, Erdem Kemalettin, Oruc Ahmet, Kilinc Nihal, Eren Nesimi
Department of Thoracic and Cardiovascular Surgery, Dicle University, School of Medicine, Diyarbakir, Turkey.
Cardiovasc Surg. 2003 Oct;11(5):375-9. doi: 10.1016/S0967-2109(03)00077-2.
The purpose of this study was to investigate the effect of N-acetylcysteine (NAC) on spinal cord ischemia-reperfusion (I-R) in rabbits. Thirty rabbits were divided into five equal groups, group I (sham-operated, no I-R), group II (control, only I-R), group III (I-R+NAC), group IV (I-R+hypothermia), group V (I-R+NAC+hypothermia). Spinal cord ischemia was induced by clamping the aorta both below the left renal artery and above the aortic bifurcation. Forty-eight hours postoperatively, the motor function of the lower limbs was evaluated in each animal according to Tarlov Score. Spinal cord samples were taken to evaluate the histopathological changes. The sham-operated rabbits (group I) showed no neurologic deficit (Score=4). Paraplegia (Score=0) developed in all rabbits in the control group (group II). Administration of 50 mg/kg of NAC (group III) resulted in significant reduction of motor dysfunction (Score=3.1+/-1.3, p=0.002). Application of hypothermia alone (group IV) showed significant recovery of motor functions (Score=3.0+/-1.1, p=0.002), and combination of hypothermia and 50 mg/kg of NAC (group V) showed complete recovery of lower limb motor function (Score=4, p=0.001). Histologic examination of the spinal cord in rabbits with paraplegia revealed several injured neurons. The cords of animals with no motor function deficits showed only minimal cellular infiltrates in the gray matter, and there was good preservation of nerve cells. NAC showed protective effects of the spinal cord. Moderate hypothermia alone also showed protective effects. Combined use of NAC and hypothermia resulted in highly significant recovery of spinal cord function.
本研究的目的是探讨N-乙酰半胱氨酸（NAC）对兔脊髓缺血再灌注（I-R）的影响。将30只兔分为五组，每组数量相等，第一组（假手术组，无I-R），第二组（对照组，仅I-R），第三组（I-R+NAC），第四组（I-R+低温），第五组（I-R+NAC+低温）。通过夹闭左肾动脉下方和主动脉分叉上方的主动脉来诱导脊髓缺血。术后48小时，根据Tarlov评分评估每只动物下肢的运动功能。采集脊髓样本以评估组织病理学变化。假手术兔（第一组）未出现神经功能缺损（评分=4）。对照组（第二组）的所有兔均发生截瘫（评分=0）。给予50mg/kg的NAC（第三组）导致运动功能障碍显著减轻（评分=3.1±1.3，p=0.002）。单独应用低温（第四组）显示运动功能有显著恢复（评分=3.0±1.1，p=0.002），而低温与50mg/kg的NAC联合应用（第五组）显示下肢运动功能完全恢复（评分=4，p=0.001）。对截瘫兔脊髓的组织学检查发现有多个受损神经元。无运动功能缺损动物的脊髓仅在灰质中有少量细胞浸润，神经细胞保存良好。NAC对脊髓有保护作用。单独的中度低温也显示出保护作用。NAC与低温联合使用导致脊髓功能高度显著恢复。
