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心脏骤停后分级目标温度管理对脑葡萄糖时空特征的影响。

Effect of Graded Targeted Temperature Management on Cerebral Glucose Spatiotemporal Characteristics after Cardiac Arrest.

出版信息

Annu Int Conf IEEE Eng Med Biol Soc. 2022 Jul;2022:182-185. doi: 10.1109/EMBC48229.2022.9871454.

Abstract

Cardiac arrest (CA) is a fatal disease with high rates of neurological impairment. At present, targeted temperature management (TTM) is the only strategy with firm clinical evidence to prove its effectiveness. However, there is still controversy on the implementation of TTM, particularly on its depth, with a lack of elucidated underlying therapeutic mechanisms. Six Wistar rats were subjected to 8 min asphyxia-CA and randomly divided into TTM at 33C(n=3) or 35 C groups (n=3). The spatiotemporal characteristics of cerebral glucose metabolism after CA were investigated by 18F-FDG microPET/CT. Myelin Basic Protein (MBP) immunofluorescence staining was used to assess acute injury and recovery of oligodendrocytes. Functional recovery was evaluated using the neurological deficit score (NDS). There was a significant improvement in functional recovery by NDS (p < 0.05) in the 33C group compared with the 35 C group. Glucose metabolism of the 33 C group was higher than that of the 35C group early after resuscitation (within 10 minutes). Immunofluorescence analysis showed that positive MBP signals in the cortex and hippocampus in the 33C group were greater than in the 35C group. In conclusion, compared to 35C TTM, 33 C TTM changed the spatiotemporal characteristics of brain glucose metabolisms with improved neurological function, which may be through oligodendrocyte participation.

摘要

心脏骤停(CA)是一种致命疾病,具有很高的神经损伤率。目前,靶向体温管理(TTM)是唯一具有确凿临床证据证明其有效性的策略。然而,对于 TTM 的实施仍存在争议,特别是在其深度方面,其潜在的治疗机制仍不清楚。将 6 只 Wistar 大鼠置于 8 分钟窒息-CA 中,并随机分为 TTM 33°C(n=3)或 35°C 组(n=3)。通过 18F-FDG microPET/CT 研究 CA 后大脑葡萄糖代谢的时空特征。采用髓鞘碱性蛋白(MBP)免疫荧光染色评估少突胶质细胞的急性损伤和恢复。采用神经功能缺损评分(NDS)评估功能恢复。与 35°C 组相比,33°C 组的 NDS 功能恢复明显改善(p<0.05)。复苏后早期(10 分钟内),33°C 组的葡萄糖代谢高于 35°C 组。免疫荧光分析显示,33°C 组皮质和海马中的 MBP 阳性信号大于 35°C 组。总之,与 35°C TTM 相比,33°C TTM 改变了脑葡萄糖代谢的时空特征,改善了神经功能,这可能是通过少突胶质细胞参与的。

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