Nazli Yunus, Colak Necmettin, Namuslu Mehmet, Erdamar Husamettin, Haltas Hacer, Alpay Mehmet Fatih, Nuri Aksoy Omer, Olgun Akkaya Ismail, Cakir Omer
Department of Cardiovascular Surgery, Faculty of Medicine, University of Turgut Ozal, Ankara, Turkey.
Department of Cardiovascular Surgery, Faculty of Medicine, University of Turgut Ozal, Ankara, Turkey.
J Cardiothorac Vasc Anesth. 2015 Apr;29(2):351-9. doi: 10.1053/j.jvca.2014.06.028. Epub 2014 Nov 20.
The aim of this study was to evaluate the pretreatment effect of cilostazol on spinal cord ischemia-reperfusion injury.
Prospective, interventional study.
Research laboratory, single institution.
Twenty-four New Zealand white rabbits.
Twenty-four rabbits were divided into 3 equal groups: group I (sham), group II (ischemia-reperfusion, control group), and group III (cilostazol, administered orally 30 mg/kg/day for 3 days before the surgery). Spinal cord ischemia was induced by clamping the aorta both below the left renal artery and above the iliac bifurcation for 30 minutes. Seventy-two hours postoperatively, the motor function of the lower limbs was evaluated in each animal according to the modified Tarlov score. Spinal cord and blood samples were taken for histopathologic and biochemical analyses at the 72nd hour of reperfusion.
All rabbits in the ischemia-reperfusion group (group II) showed severe neurologic deficits. The median (IQR) Tarlov scores postoperatively at 72 hours in groups I, II, and III were 5.0(-), 2.0(1.0), and 4.5(1.0), respectively. Administration of cilostazol resulted in a significant reduction in motor dysfunction when compared with the ischemia-reperfusion group (p<0.001). In the ischemia-reperfusion group, serum and tissue glutathione peroxidase and superoxide dismutase activity were significantly less compared with the sham group (group I) (p<0.05). Serum and tissue glutathione peroxidase and superoxide dismutase levels in the cilostazol-treated group (group III) were higher compared with the ischemia-reperfusion group (p<0.05). In the cilostazol-treated group, serum and tissue malondialdehyde levels were lower compared with the ischemia-reperfusion group (p<0.05). Histopathologic analysis found decreased neuronal injury in the cilostazol group when compared with the ischemia-reperfusion group (p< 0.05).
This study showed that pretreatment with cilostazol significantly ameliorated neurologic functional outcome and attenuated neuronal histopathologic injury after transient aortic occlusion in rabbits.
本研究旨在评估西洛他唑对脊髓缺血再灌注损伤的预处理效果。
前瞻性干预研究。
单一机构的研究实验室。
24只新西兰白兔。
将24只兔子分为3组,每组数量相等:第一组(假手术组)、第二组(缺血再灌注组,对照组)和第三组(西洛他唑组,术前3天每天口服30mg/kg)。通过夹闭左肾动脉下方和髂总动脉分叉上方的主动脉30分钟诱导脊髓缺血。术后72小时,根据改良的塔尔洛夫评分评估每只动物下肢的运动功能。在再灌注72小时时采集脊髓和血液样本进行组织病理学和生化分析。
缺血再灌注组(第二组)的所有兔子均表现出严重的神经功能缺损。第一组、第二组和第三组术后72小时的塔尔洛夫评分中位数(四分位间距)分别为5.0(-)、2.0(1.0)和4.5(1.0)。与缺血再灌注组相比,西洛他唑治疗显著降低了运动功能障碍(p<0.001)。在缺血再灌注组中,血清和组织中的谷胱甘肽过氧化物酶和超氧化物歧化酶活性显著低于假手术组(第一组)(p<0.05)。与缺血再灌注组相比,西洛他唑治疗组(第三组)的血清和组织中的谷胱甘肽过氧化物酶和超氧化物歧化酶水平更高(p<0.05)。在西洛他唑治疗组中,血清和组织中的丙二醛水平低于缺血再灌注组(p<0.05)。组织病理学分析发现,与缺血再灌注组相比,西洛他唑组的神经元损伤减少(p<0.05)。
本研究表明,西洛他唑预处理可显著改善兔短暂性主动脉闭塞后的神经功能结局,并减轻神经元组织病理学损伤。