Division of Cardiovascular Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan.
Division of Cardiovascular Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan.
J Thorac Cardiovasc Surg. 2016 Nov;152(5):1401-1409. doi: 10.1016/j.jtcvs.2016.04.095. Epub 2016 Aug 12.
We evaluated the effect of cerebrospinal fluid oxygenation for the prevention of spinal cord ischemic injury after infrarenal aortic occlusion in a rabbit model.
Twenty white Japanese rabbits were categorized into the following 4 groups (5 in each): group S (sham), balloon catheter insertion on to the aorta; group C (control), spinal cord ischemic injury by infrarenal abdominal aortic balloon occlusion for 15 minutes; group N (nonoxygenated), spinal cord ischemic injury with cerebrospinal fluid replacement by nonoxygenated artificial cerebrospinal fluid; and group O (oxygenated), spinal cord ischemic injury with cerebrospinal fluid replacement by nanobubble-oxygenated artificial cerebrospinal fluid. The changes in cerebrospinal fluid partial pressure of oxygen during the peri-ischemic period, modified Tarlov score, and histopathology of the spinal cord 48 hours after aortic maneuvers were evaluated.
Cerebrospinal fluid partial pressure of oxygen significantly increased in group O compared with group N after cerebrospinal fluid replacement (254.5 ± 54.8 mm Hg vs 136.1 ± 43.5 mm Hg, P = .02). After 15 minutes of spinal cord ischemic injury, cerebrospinal fluid partial pressure of oxygen in group C decreased to 65.8 ± 18.6 mm Hg compared with baseline (148.8 ± 20.6 mm Hg, P < .01), whereas cerebrospinal fluid partial pressure of oxygen in group O was maintained at remarkably high levels after spinal cord ischemic injury (291.9 ± 51.8 mm Hg), which was associated with improved neurologic function, with 20% of spinal cord ischemic injury having a Tarlov score less than 5 compared with 100% of spinal cord ischemic injury in group C. Preservation of anterior horn neurons in groups N and O was confirmed by histopathologic analysis with significant reduction of degenerated neurons compared with group C.
Cerebrospinal fluid oxygenation with artificial cerebrospinal fluid can exert a protective effect against spinal cord ischemic injury in rabbits.
我们评估了蛛网膜下腔氧合对兔模型肾下主动脉闭塞后脊髓缺血性损伤的预防作用。
20 只日本白兔分为以下 4 组（每组 5 只）：S 组（假手术），将气囊导管插入主动脉；C 组（对照组），肾下腹主动脉球囊阻塞 15 分钟造成脊髓缺血性损伤；N 组（非氧合组），非氧合人工脑脊液替代蛛网膜下腔脑脊液；O 组（氧合组），纳米气泡氧合人工脑脊液替代蛛网膜下腔脑脊液。评估缺血期前后脑脊液氧分压的变化、改良 Tarlov 评分和主动脉操作后 48 小时脊髓的组织病理学变化。
O 组脑脊液氧分压在脑脊液置换后明显高于 N 组（254.5±54.8mmHg 比 136.1±43.5mmHg，P=0.02）。脊髓缺血 15 分钟后，C 组脑脊液氧分压降至 65.8±18.6mmHg，与基线相比（148.8±20.6mmHg，P<0.01），而 O 组脊髓缺血后脑脊液氧分压仍维持在较高水平（291.9±51.8mmHg），这与神经功能改善相关，脊髓缺血损伤 Tarlov 评分<5 的比例为 20%，而 C 组为 100%。组织病理学分析证实 N 组和 O 组前角神经元得到保存，与 C 组相比，退变神经元明显减少。
人工脑脊液氧合可对兔脊髓缺血性损伤产生保护作用。
