Aaltonen Minna, Soukka Hanna, Halkola Lauri, Kalimo Hannu, Holopainen Irma E, Kääpä Pekka O
Research Centre of Applied and Preventive Cardiovascular Medicine (CAPC), University Hospital of Turku, Turku, Finland.
Acta Paediatr. 2005 Oct;94(10):1468-75. doi: 10.1111/j.1651-2227.2005.tb01822.x.
Meconium aspiration-induced hypertensive lung injury, especially when connected with perinatal asphyxia, has been associated with brain damage. We aimed to determine the neuronal injury induced by pulmonary meconium contamination alone and with concurrent asphyxia.
36 anaesthetized and ventilated newborn piglets were haemodynamically monitored for 6 h. Seven piglets without concurrent asphyxia and seven piglets with asphyxia were instilled with a bolus of human meconium intratracheally. Seven piglets had only asphyxia and 15 piglets served as controls. The brains were studied histologically.
Meconium aspiration did not change systemic haemodynamics acutely, while its combination with asphyxia diminished the abrupt postasphyxic systemic hypertensive peak and resulted in a transient increase in carotid artery flow, not seen after isolated asphyxia. Systemic pressure declined after 4 h in all insulted groups, but only isolated asphyxia was associated with a sustained decrease in carotid artery flow. Arterial oxygenation remained normal, except during the acute insults. Brain examination after meconium instillation indicated neuronal injury, especially in the CA3 region of the hippocampus. Asphyxia resulted in neuronal injury in the cortical, cerebellar and hippocampal hilus regions.
Severe meconium aspiration itself may result in hippocampal neuronal injury.
胎粪吸入所致的高血压性肺损伤，尤其是与围产期窒息相关时，已被证实与脑损伤有关。我们旨在确定单纯肺胎粪污染以及同时伴有窒息时所引起的神经元损伤。
对36只麻醉通气的新生仔猪进行6小时的血流动力学监测。7只无窒息的仔猪和7只伴有窒息的仔猪经气管内注入一剂人胎粪。7只仔猪仅有窒息，15只仔猪作为对照。对大脑进行组织学研究。
胎粪吸入并未急性改变全身血流动力学，而其与窒息相结合则减弱了窒息后全身高血压的峰值，并导致颈动脉血流短暂增加，这在单纯窒息后未见。所有受损伤组在4小时后全身血压下降，但只有单纯窒息与颈动脉血流持续减少有关。除急性损伤期间外，动脉氧合保持正常。注入胎粪后的脑部检查显示存在神经元损伤，尤其是在海马体的CA3区域。窒息导致皮质、小脑和海马体门区的神经元损伤。
严重的胎粪吸入本身可能导致海马体神经元损伤。
