Tóth Z, Gyorimolnár I, Abrahám H, Fazekas L, Hevesi A, Repa I, Papp L
Division of Cardiac Surgery in Heart Institute of the Faculty of Medicine, University of Pécs, Ifjuság ut 13, 7624 Pécs, Hungary.
Prague Med Rep. 2005;106(3):243-52.
Whether cardiopulmonary bypass alone or together with the manipulation of the aorta produce neurological complication remains controversial. Using a domestic pig model of cardiopulmonary bypass, we investigated the immediate effects of aortic cannulation and cardiopulmonary bypass on neuronal injury in different brain regions. We compared the presence of neuronal injury in three experimental groups: non-operated controls (n = 3); operated controls with aortic cannulation without cardiopulmonary bypass (n = 5); operated animals undergoing cardiopulmonary bypass (n = 5). Pyknotic cells were counted in the prefrontal cortex, cerebellum and in the hippocampal formation. Calretinin immunohistochemistry was used to show possible ischemic damages in the hippocampus which is known to be one of the most sensitive brain regions to ischemia. Decreased calretinin immunoreaction and reduced number of calretinin-positive neurons were observed in the hippocampal dentate gyrus following aortic cannulation or cardiopulmonary bypass compared to the non-operated control group. Changes were more severe following cardiopulmonary bypass than after cannulation of the aorta alone. The frequency of pyknotic cell nuclei was not different in the control and experimental groups. Our experimental study suggests that both cannulation of the aorta alone and cardiopulmonary bypass affect a selected population of neurons.
仅体外循环或体外循环与主动脉操作共同作用是否会引发神经并发症仍存在争议。我们使用国产猪体外循环模型，研究了主动脉插管和体外循环对不同脑区神经元损伤的即时影响。我们比较了三个实验组神经元损伤的情况：未手术对照组（n = 3）；进行主动脉插管但未进行体外循环的手术对照组（n = 5）；接受体外循环的手术动物组（n = 5）。对前额叶皮质、小脑和海马结构中的固缩细胞进行计数。采用钙视网膜蛋白免疫组织化学法显示海马体中可能存在的缺血损伤，海马体是已知对缺血最敏感的脑区之一。与未手术对照组相比，主动脉插管或体外循环后海马齿状回中钙视网膜蛋白免疫反应降低，钙视网膜蛋白阳性神经元数量减少。体外循环后的变化比单纯主动脉插管后更严重。对照组和实验组中固缩细胞核的频率没有差异。我们的实验研究表明，单纯主动脉插管和体外循环都会影响特定的神经元群体。
