Iwamoto Satoshi, Higashi Akihiro, Ueno Tetsuya, Goto Masamichi, Iguro Yoshifumi, Sakata Ryuzo
Department of Thoracic and Cardiovascular Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima City, Kagoshima, Japan.
Interact Cardiovasc Thorac Surg. 2009 Jun;8(6):606-9. doi: 10.1510/icvts.2008.197244. Epub 2009 Mar 16.
Prevention of paraplegia remains an important issue in repair of descending thoracic and thoracoabdominal aneurysms. Therefore, we investigated the protective effect of sivelestat sodium hydrate (ONO-5046) on ischemia-induced spinal cord damage in a rabbit model. Twenty New Zealand white rabbits were divided into two equal groups; ONO-5046 (1.6 mg/kg)+isotonic NaCl (30 ml) was administered selectively to the spinal cord via the lumbar arteries for the first 3 min during 30 min of infra-renal aorta clamping in the experimental group (group E), whereas NaCl was given alone in the control group (group C). Motor function of the lower limbs was assessed two days later by Tarlov criteria. The number of intact motor neurons in the anterior segment of the cord (L5 level) was counted after hematoxylin-eosin staining and the number of apoptotic motor neurons after TUNEL staining. Motor function of the lower limbs in group E was significantly better (P=0.003) than that in group C. The number of intact motor neurons was greater and of apoptotic motor neurons was less in group E than C. Selective infusion of sivelestat sodium hydrate directly into the spinal cord via the lumbar arteries significantly attenuated functional and morphological ischemia-induced spinal cord injury.
预防截瘫仍然是降胸段和胸腹段动脉瘤修复中的一个重要问题。因此，我们在兔模型中研究了水合西维来司他钠（ONO - 5046）对缺血性脊髓损伤的保护作用。将20只新西兰白兔平均分为两组；在实验组（E组）肾下腹主动脉夹闭30分钟的前3分钟，通过腰动脉将ONO - 5046（1.6mg/kg）+等渗氯化钠（30ml）选择性地注入脊髓，而对照组（C组）仅给予氯化钠。两天后根据塔尔洛夫标准评估下肢运动功能。苏木精 - 伊红染色后计数脊髓前角（L5水平）完整运动神经元的数量，TUNEL染色后计数凋亡运动神经元的数量。E组下肢运动功能明显优于C组（P = 0.003）。E组完整运动神经元的数量多于C组，凋亡运动神经元的数量少于C组。通过腰动脉将水合西维来司他钠直接选择性注入脊髓可显著减轻缺血性脊髓损伤的功能和形态学改变。
