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犬模型中动脉缺血或静脉淤血引起的脊髓血流、氧张力、动作电位和血管通透性的变化。

Changes of blood flow, oxygen tension, action potential and vascular permeability induced by arterial ischemia or venous congestion on the spinal cord in canine model.

机构信息

Faculty of Medical Sciences, Department of Orthopaedics and Rehabilitation Medicine, The University of Fukui, Shimoaizuki 23, Matsuoka, Fukui 910-1193, Japan.

出版信息

J Orthop Res. 2013 Jan;31(1):139-46. doi: 10.1002/jor.22197. Epub 2012 Aug 21.

Abstract

It is generally considered that the genesis of myelopathy associated with the degenerative conditions of the spine may result from both mechanical compression and circulatory disturbance. Many references about spinal cord tissue ischemic damage can be found in the literature, but not detailed studies about spinal cord microvasculature damage related to congestion or blood permeability. This study investigates the effect of ischemia and congestion on the spinal cord using an in vivo model. The aorta was clamped as an ischemia model of the spinal cord and the inferior vena cava was clamped as a congestion model at the 6th costal level for 30 min using forceps transpleurally. Measurements of blood flow, partial oxygen pressure, and conduction velocity in the spinal cord were repeated over a period of 1 h after release of clamping. Finally, we examined the status of blood-spinal cord barrier under fluorescence and transmission electron microscope. Immediately after clamping of the inferior vena cava, the central venous pressure increased by about four times. Blood flow, oxygen tension and action potential were more severely affected by the aorta clamping; but this ischemic model did not show any changes of blood permeability in the spinal cord. The intramedullar edema was more easily produced by venous congestion than by arterial ischemia. In conclusions, venous congestion may be a preceding and essential factor of circulatory disturbance in the compressed spinal cord inducing myelopathy.

摘要

一般认为,与脊柱退行性病变相关的脊髓病的病因可能源于机械压迫和循环障碍。文献中有许多关于脊髓组织缺血性损伤的参考文献,但没有详细研究与充血或血液通透性相关的脊髓微血管损伤。本研究使用体内模型研究了缺血和充血对脊髓的影响。通过胸腔内用钳子夹闭胸主动脉作为脊髓缺血模型,夹闭第 6 肋水平下腔静脉作为充血模型,持续 30 分钟。在解除夹闭后 1 小时内重复测量脊髓血流量、局部氧分压和传导速度。最后,我们在荧光和透射电镜下检查血脊髓屏障的状态。下腔静脉夹闭后,中心静脉压升高约 4 倍。血流、氧分压和动作电位受胸主动脉夹闭的影响更严重;但是这种缺血模型并没有显示出脊髓内血液通透性的任何变化。静脉充血比动脉缺血更容易引起髓内水肿。总之,静脉充血可能是导致脊髓病的受压脊髓循环障碍的一个前期和必要因素。

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