Jiang Ji-Yao, Liang Yu-Ming, Luo Qi-Zhong, Zhu Cheng
Department of Neurosurgery, RenJi Hospital, Shanghai Second Medical University, Shanghai, People's Republic of China.
Neurosurgery. 2004 Mar;54(3):713-7; discussion 717-8. doi: 10.1227/01.neu.0000109535.58429.49.
To investigate the effects of mild hypothermia on brain microdialysate lactate after fluid percussion traumatic brain injury (TBI) in rats.
Brain dialysate lactate before and after fluid percussion brain injury (2.1 +/- 0.2 atm) was measured in rats with preinjury mild hypothermia (32 degrees C), postinjury mild hypothermia (32 degrees C), injury normothermia (37 degrees C), and the sham control group. Mild hypothermia (32 degrees C) was induced by partial immersion in a water bath (0 degrees C) under general anesthesia and maintained for 2 hours.
In the normothermia TBI group, brain extracellular fluid lactate increased from 0.311 +/- 0.03 to 1.275 +/- 0.08 mmol/L within 30 minutes after TBI (P < 0.01) and remained at a high level (0.546 +/- 0.05 mmol/L) (P < 0.01) at 2 hours after injury. In the postinjury mild hypothermic group, brain extracellular fluid lactate increased from 0.303 +/- 0.03 to 0.875 +/- 0.05 mmol/L at 15 minutes after TBI (P < 0.01) and then gradually decreased to 0.316 +/- 0.04 mmol/L at 2 hours after TBI (P > 0.05). In the preinjury mild hypothermic group, brain extracellular fluid lactate remained at normal levels after injury (P > 0.05).
The cerebral extracellular fluid lactate level increases significantly after fluid percussion brain injury. Preinjury mild hypothermia completely inhibits the cerebral lactate accumulation, and early postinjury mild hypothermia significantly blunts the increase of cerebral lactate level after fluid percussion injury.
研究轻度低温对大鼠液压冲击性脑损伤(TBI)后脑微透析液中乳酸水平的影响。
在伤前轻度低温(32℃)、伤后轻度低温(32℃)、损伤常温(37℃)及假手术对照组的大鼠中,测量液压冲击性脑损伤(2.1±0.2个大气压)前后脑透析液中的乳酸水平。在全身麻醉下,通过部分浸入0℃水浴诱导轻度低温(32℃)并维持2小时。
在常温TBI组中,TBI后30分钟内脑细胞外液乳酸水平从0.311±0.03毫摩尔/升增加到1.275±0.08毫摩尔/升(P<0.01),伤后2小时仍维持在较高水平(0.546±0.05毫摩尔/升)(P<0.01)。在伤后轻度低温组中,TBI后15分钟脑细胞外液乳酸水平从0.303±0.03毫摩尔/升增加到0.875±0.05毫摩尔/升(P<0.01),然后在TBI后2小时逐渐降至0.316±0.04毫摩尔/升(P>0.05)。在伤前轻度低温组中,伤后脑细胞外液乳酸水平维持在正常水平(P>0.05)。
液压冲击性脑损伤后脑细胞外液乳酸水平显著升高。伤前轻度低温可完全抑制脑乳酸积累,伤后早期轻度低温可显著减轻液压冲击性损伤后脑乳酸水平的升高。