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蛛网膜下腔出血后迷走神经缺血诱导的肺免疫成分梗死:一项实验研究。

Vagal Ischemia Induced Lung Immune Component Infarct Following Subarachnoid Hemorrhage: An Experimental Study.

作者信息

Atalay Canan, Gundogdu Betul, Aydin Mehmet Dumlu

机构信息

Ataturk University, Faculty of Medicine, Department of Anesthesiology, Erzurum, Turkey.

出版信息

Turk Neurosurg. 2017;27(4):509-515. doi: 10.5137/1019-5149.JTN.16940-16.3.

Abstract

AIM

Neurogenic pulmonary edema (NPE) is the most serious complication of subarachnoid hemorrhage (SAH). As vagal nerves have vital roles in lung functions, vagal ischemia may have a causative role in the pathogenesis of NPE. We examined whether there was a relationship between vagal complex ischemia and lung immune complexes occupying the lymph node infarct in SAH.

MATERIAL AND METHODS

Thirty-two rabbits were divided into three groups: Control (n=5), SHAM (n=5) and SAH group (n=22). SAH was created by autologous blood injection into the cisterna magna and followed-up for 3 weeks. Vasospasm index (VSI) was defined as the ratio of the lung lymph node arteries (LLNA) wall section (wall ring) surface to the lumen surface. Degenerated axon numbers of vagal nerves, neuron densities of the nodose ganglion (NG) and VSIs of LLNA were compared for all groups.

RESULTS

The mean degenerated vagal nerve axon density, neuron density of NG, and VSI of LLNA were 26±8/mm < sup > 2 < /sup > , 30±5/mm < sup > 3 < /sup > , and 0.777±0.048 in the control group; 1300±100/mm2, 720±90/mm < sup > 3 < /sup > , and 1.148±0.090 in the animals with slight vasospasm (n=12); and 7300±530/mm < sup > 2 < /sup > , 5610±810/mm3, and 1.500±0.120 in the animals with severe vasospasm (n=10), respectively.

CONCLUSION

Degenerated vagal axon and NG neuron density may be a causative factor in the development of LLNA vasospasm induced lymph node infarct in SAH. Lung lymph node infarct may be an important factor in the prognosis of NPE.

摘要

目的

神经源性肺水肿(NPE)是蛛网膜下腔出血(SAH)最严重的并发症。由于迷走神经在肺功能中起重要作用,迷走神经缺血可能在NPE的发病机制中起致病作用。我们研究了SAH中迷走神经复合体缺血与占据肺淋巴结梗死的肺免疫复合物之间是否存在关系。

材料与方法

32只兔子分为三组:对照组(n = 5)、假手术组(n = 5)和SAH组(n = 22)。通过将自体血注入枕大池制造SAH,并随访3周。血管痉挛指数(VSI)定义为肺淋巴结动脉(LLNA)壁截面(壁环)表面积与管腔表面积之比。比较所有组的迷走神经变性轴突数量、结状神经节(NG)神经元密度和LLNA的VSI。

结果

对照组平均迷走神经变性轴突密度、NG神经元密度和LLNA的VSI分别为26±8/mm²、30±5/mm³和0.777±0.048;轻度血管痉挛动物(n = 12)分别为1300±100/mm²、720±90/mm³和1.148±0.090;重度血管痉挛动物(n = 10)分别为7300±530/mm²、5610±810/mm³和1.500±0.120。

结论

迷走神经轴突变性和NG神经元密度可能是SAH中LLNA血管痉挛诱导淋巴结梗死发生的致病因素。肺淋巴结梗死可能是NPE预后的一个重要因素。

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