Department of Anesthesiology, Xijing Hospital, Fourth Military Medical University, Xi'an, China.
J Surg Res. 2011 Aug;169(2):292-300. doi: 10.1016/j.jss.2009.11.707. Epub 2009 Dec 8.
Paraplegia is one of the most common complications following aortic aneurismal surgery. The present study examined the hypothesis that neuroprotection of sevoflurane postconditioning (PostC) against spinal cord reperfusion injury is associated with free radicals-mediated up-regulation of antioxidant enzymes in rabbits.
New Zealand White rabbits were subjected to sevoflurane PostC, oxygen (O(2)), or sham treatment at the onset of spinal cord reperfusion for 10 min. Spinal cord ischemia was induced by clamping the aorta both below the left renal artery and above the aortic bifurcation. Forty-eight hours after reperfusion, the motor function of the lower limbs was evaluated and the lumbar spinal cord segment (L5-7) was harvested for histopathologic and biochemical analyses in the presence or absence of N-2-mercaptopropionylglycine, a potent oxygen free radical scavenger.
Activities of superoxide dismutase and catalase in spinal cord tissue were increased in the sevoflurane PostC group 1 h after reperfusion and retained a higher level 6 or 24 h after reperfusion. Sevoflurane PostC produced a significant reduction of the malondialdehyde content at 6, 24, and 48 h after reperfusion. A 20 min continuous administration of N-2-mercaptopropionylglycine starting 10 min before the beginning of PostC attenuated the neuroprotective effect against spinal cord ischemia, and reversed the increase of the two enzyme activities in spinal cord tissue induced by sevoflurane PostC.
An initial oxidative stress, as a trigger to up-regulate the antioxidant enzyme activities, plays an important role in the protection of sevoflurane PostC against spinal cord reperfusion injury.
截瘫是主动脉瘤手术后最常见的并发症之一。本研究检验了七氟醚后处理(PostC)对脊髓再灌注损伤的神经保护作用与自由基介导的抗氧化酶上调有关的假说。
新西兰白兔在脊髓再灌注开始时接受七氟醚 PostC、氧气(O(2))或假处理 10 分钟。通过夹闭主动脉在左肾动脉下方和主动脉分叉上方来诱导脊髓缺血。再灌注 48 小时后,评估下肢的运动功能,并在存在或不存在 N-2-巯基丙酰甘氨酸(一种有效的氧自由基清除剂)的情况下收获腰段脊髓节段(L5-7)进行组织病理学和生化分析。
再灌注 1 小时后,七氟醚 PostC 组脊髓组织中超氧化物歧化酶和过氧化氢酶的活性增加,并在再灌注后 6 或 24 小时保持较高水平。七氟醚 PostC 在再灌注后 6、24 和 48 小时降低了丙二醛的含量。从 PostC 开始前 10 分钟开始连续 20 分钟给予 N-2-巯基丙酰甘氨酸,可减弱对脊髓缺血的神经保护作用,并逆转七氟醚 PostC 诱导的脊髓组织中两种酶活性的增加。
初始的氧化应激作为触发因素,上调抗氧化酶的活性,在七氟醚 PostC 对脊髓再灌注损伤的保护中起着重要作用。