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胸交感神经核缺血:实验性诱导脊髓蛛网膜下腔出血后对降低心率的影响。

Thoracic sympathetic nuclei ischemia: Effects on lower heart rates following experimentally induced spinal subarachnoid hemorrhage.

作者信息

Koza Y, Bayram E, Armagan Koza E, Aydin M Dumlu, Soyalp C, Atalay C, Şipal S

机构信息

Department of cardiology, medical faculty of Ataturk university, Erzurum, Turkey.

Department of cardiology, medical faculty of Ataturk university, Erzurum, Turkey.

出版信息

Neurochirurgie. 2020 Jun;66(3):155-161. doi: 10.1016/j.neuchi.2019.12.016. Epub 2020 May 7.

Abstract

BACKGROUND

The neuropathological mechanism of heart rhythm disorders, following spinal cord pathologies, to our knowledge, has not yet been adequately investigated. In this study, the effect of the ischemic neurodegeneration of the thoracic sympathetic nuclei (TSN) on the heart rate (HR) was examined following a spinal subarachnoid hemorrhage (SSAH).

METHODS

This study was conducted on 22 rabbits. Five rabbits were used as a control group, five as SHAM, and twelve as a study group. The animals' HRs were recorded via monitoring devices on the first day, and those results were accepted as baseline values. The HRs were remeasured after injecting 0.5 cc of isotonic saline for SHAM and 0.5 cc of autolog arterial blood into the thoracic spinal subarachnoid space at T4-T5 for the study group. After a three-week follow-up with continuous monitoring of their HRs, the rabbit's thoracic spinal cords and stellate ganglia were extracted. The specimens were evaluated by histopathological methods. The densities of degenerated neurons in the TSN and stellate ganglia were compared with the HRs.

RESULTS

The mean HRs and mean degenerated neuron density of the TSN and stellate ganglia in control group were 251±18/min, 5±2/mm, and 3±1/mm, respectively. The mean HRs and the mean degenerated neuron density of the TSN and stellate ganglia were detected as 242±13/min, 6±2/mm, and 4±2/mm in SHAM (P>0.05 vs. control); 176±19/min, 94±12/mm, and 28±6/mm in the study group (P<0.0001 vs. control and P<0.005 vs. SHAM), respectively.

CONCLUSIONS

SAH induced TSN neurodegeneration may have been responsible for low HRs following SSAH. To date this has not been mentioned in the literature.

摘要

背景

据我们所知,脊髓病变后心律失常的神经病理机制尚未得到充分研究。在本研究中,我们检测了脊髓蛛网膜下腔出血(SSAH)后胸段交感神经核(TSN)缺血性神经变性对心率(HR)的影响。

方法

本研究共纳入22只家兔。5只家兔作为对照组,5只作为假手术组,12只作为研究组。在第一天通过监测设备记录动物的心率,这些结果被视为基线值。假手术组注射0.5 cc等渗盐水,研究组在T4 - T5水平向胸段脊髓蛛网膜下腔注入0.5 cc自体动脉血后再次测量心率。在连续监测心率三周后,取出家兔的胸段脊髓和星状神经节。通过组织病理学方法对标本进行评估。将TSN和星状神经节中变性神经元的密度与心率进行比较。

结果

对照组TSN和星状神经节的平均心率及平均变性神经元密度分别为251±18次/分钟、5±2个/mm和3±1个/mm。假手术组TSN和星状神经节的平均心率及平均变性神经元密度分别检测为242±13次/分钟、6±2个/mm和4±2个/mm(与对照组相比,P>0.05);研究组分别为176±19次/分钟、94±12个/mm和28±6个/mm(与对照组相比,P<0.0001;与假手术组相比,P<0.005)。

结论

SAH诱导的TSN神经变性可能是SSAH后心率降低的原因。迄今为止,文献中尚未提及这一点。

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