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全身低温对胸主动脉缺血再灌注模型的影响。

The effects of systemic hypothermia on a murine model of thoracic aortic ischemia reperfusion.

机构信息

Division of Vascular and Endovascular Surgery, Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, Mass, USA.

出版信息

J Vasc Surg. 2010 Aug;52(2):435-43. doi: 10.1016/j.jvs.2010.03.021. Epub 2010 Jun 11.

Abstract

INTRODUCTION

Hypothermia is widely used to mediate ischemia-reperfusion injury associated with repair of the thoracoabdominal aorta. Experiments were designed in a murine model of thoracic aortic ischemia-reperfusion (TAR) to evaluate the effect of moderate systemic hypothermia on neurologic function, spinal cord morphology, and indices of inflammation in critical organs.

METHODS

C57BL/6 mice were subjected to TAR under hypothermic (34 degrees C) or normothermic (38 degrees C) conditions, followed by 24 or 48 hours of normothermic reperfusion. Neurologic functions were assessed during reperfusion. Spinal cords were examined at 24 and 48 hours after reperfusion, and the degree of injury qualified by counting the number of viable motor neurons within the anterior horns. Keratinocyte chemokine, interleukin-6, and myeloperoxidase levels were measured from lung, liver, and kidney at 24 and 48 hours.

RESULTS

Normothermic TAR resulted in a dense neurologic deficit in all mice throughout the reperfusion period. Mice subjected to TAR under hypothermic conditions had transient, mild neurologic deficit during the initial periods of reperfusion. Between 24 and 48 hours, delayed paralysis developed in half of these mice, whereas the other half remained neurologically intact. Spinal cord histology showed a graded degree of injury that correlated with neurologic function. There was no correlation between markers of inflammation in various organs and neurologic outcomes following TAR.

CONCLUSION

Systemic moderate hypothermia was protective against immediate paralysis after TAR in all cases and was associated with delayed paralysis in 50% of mice. This study suggests that delayed-onset paralysis may be the result of a local insult, rather than a systemic inflammatory event, precipitating spinal cord injury.

摘要

简介

低温被广泛用于介导与胸主动脉修复相关的缺血再灌注损伤。本实验在胸主动脉缺血再灌注(TAR)的小鼠模型中设计,以评估中度全身低温对神经功能、脊髓形态和关键器官炎症指标的影响。

方法

C57BL/6 小鼠在低温(34°C)或常温(38°C)条件下进行 TAR,随后进行 24 或 48 小时的常温再灌注。再灌注期间评估神经功能。再灌注后 24 小时和 48 小时检查脊髓,通过计数前角内存活运动神经元的数量来确定损伤程度。在 24 小时和 48 小时时从肺、肝和肾中测量角质形成细胞趋化因子、白细胞介素-6 和髓过氧化物酶水平。

结果

常温 TAR 导致所有小鼠在整个再灌注期间出现严重的神经功能缺损。在低温条件下进行 TAR 的小鼠在再灌注的初始阶段有短暂的轻度神经功能缺损。在 24 小时至 48 小时之间,其中一半的小鼠出现迟发性瘫痪,而另一半小鼠仍保持神经完整。脊髓组织学显示损伤程度呈分级,与神经功能相关。各种器官的炎症标志物与 TAR 后的神经功能结果之间没有相关性。

结论

全身中度低温对 TAR 后立即发生的瘫痪有保护作用,在 50%的小鼠中与迟发性瘫痪有关。本研究表明,迟发性瘫痪可能是局部损伤的结果,而不是引发脊髓损伤的全身性炎症事件。

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