Zhang Lihua, Cheng Huilin, Shi Jixin, Chen Jun
Department of Pathology, Nanjing Drum Tower Hospital, School of Medicine, Nanjing University, Nanjing 210002, PR China.
Surg Neurol. 2007 Feb;67(2):117-21; discussion 121. doi: 10.1016/j.surneu.2006.05.064. Epub 2006 Nov 3.
The protective effect against ischemic stroke by systemic hypothermia is limited by the cooling rate and it has severe complications. This study was designed to evaluate the effect of SBH induced by epidural cooling on infarction volume in a swine model of PMCAO.
Permanent middle cerebral artery occlusion was performed in 12 domestic swine assigned to groups A and B. In group A, the cranial and rectal temperatures were maintained at normal range (37 degrees C-39 degrees C) for 6 hours after PMCAO. In group B, cranial temperature was reduced to moderate (deep brain, <30 degrees C) and deep (brain surface, <20 degrees C) temperature and maintained at that level for 5 hours after 1 hour after PMCAO, by the epidural cooling method. All animals were euthanized 6 hours after MCAO; their brains were sectioned and stained with 2,3,5-triphenyltetrazolium chloride and their infarct volumes were calculated.
The moderate and deep brain temperature (at deep brain and brain surface) can be induced by rapid epidural cooling, whereas the rectal temperature was maintained within normal range. The infarction volume after PMCAO was significantly reduced by epidural cooling compared with controls (13.73% +/- 1.82% vs 5.62% +/- 2.57%, P < .05).
The present study has demonstrated, with histologic confirmation, that epidural cooling may be a useful strategy for reducing infarct volume after the onset of ischemia.
全身低温对缺血性中风的保护作用受降温速率限制,且有严重并发症。本研究旨在评估硬膜外降温诱导的亚低温对猪大脑中动脉闭塞(PMCAO)模型梗死体积的影响。
将12头家猪分为A组和B组,进行永久性大脑中动脉闭塞手术。A组在PMCAO后6小时将颅温和直肠温度维持在正常范围(37℃ - 39℃)。B组在PMCAO后1小时,通过硬膜外降温方法将颅温降至中度(脑深部,<30℃)和深度(脑表面,<20℃),并维持该水平5小时。所有动物在MCAO后6小时安乐死;将其大脑切片,用2,3,5 - 氯化三苯基四氮唑染色,计算梗死体积。
硬膜外快速降温可诱导脑深部和脑表面达到中度和深度低温,而直肠温度维持在正常范围内。与对照组相比,硬膜外降温显著降低了PMCAO后的梗死体积(13.73% ± 1.82% 对5.62% ± 2.57%,P <.05)。
本研究经组织学证实,硬膜外降温可能是减少缺血发作后梗死体积的有效策略。