Roos J A, Jackson-Friedman C, Lyden P
Department of Emergency Medicine, Naval Medical Center, San Diego, CA, USA.
Acad Emerg Med. 1998 Jan;5(1):18-24. doi: 10.1111/j.1553-2712.1998.tb02569.x.
To evaluate the effect of hyperbaric oxygen (HBO) therapy on neurologic outcome (assessed by the quantal bioassay approach) following acute focal cerebral ischemia in rats.
Two separate experimental trials were conducted. Trial 1, a nonblinded experiment, used 38 rats. Trial 2, a blinded experiment, used 59 rats. Focal cerebral ischemia was induced with a surgically placed intraluminal occlusion of the left middle cerebral artery; subsequent removal allowed reperfusion. Arterial occlusion times were varied from 5 to 90 minutes in trial 1, and from 3 to 45 minutes in trial 2. The control groups were maintained at ambient pressure for the duration of each trial. The trial 1 treatment group received a single 30-minute HBO treatment at 2.0 atmospheres absolute (ATA) on the initial day of ischemia. The trial 2 treatment group received 30-minute HBO treatments at 2.0 ATA daily for 4 consecutive days. The animals underwent daily 5-point neurologic examinations. A computerized quantal bioassay was used to determine the ET50--the occlusion time required to cause a neurologic abnormality in half of the animals. The control and treatment ET50 values were compared in each trial using a 2-tailed t-test. An increased ET50 for the treatment vs the control group implied a beneficial effect of HBO; a decrease, the opposite. The study had a power of 80% to detect a difference of 11.4 minutes in the ET50 for a 2-sided alpha = 0.05.
For trial 1: the HBO ET50 was 18.1 +/- 21.9 minutes and the control ET50 was 22.8 +/- 25.0 minutes (p > 0.2). For trial 2: the HBO ET50 was 9.49 +/- 17.4 minutes and the control ET50 was 14.9 +/- 14.2 minutes (p < 0.2).
HBO therapy showed no apparent benefit in a rat model as a treatment modality for acute cerebral ischemia with reperfusion.
评估高压氧(HBO)疗法对大鼠急性局灶性脑缺血后神经功能转归(采用定量生物测定法评估)的影响。
进行了两项独立的实验性试验。试验1为非盲法实验,使用了38只大鼠。试验2为盲法实验,使用了59只大鼠。通过手术将左大脑中动脉腔内闭塞诱导局灶性脑缺血;随后移除闭塞物实现再灌注。试验1中动脉闭塞时间从5分钟到90分钟不等,试验2中从3分钟到45分钟不等。在每个试验期间,对照组维持在常压环境。试验1治疗组在缺血首日接受一次2.0绝对大气压(ATA)下30分钟的HBO治疗。试验2治疗组连续4天每天接受2.0 ATA下30分钟的HBO治疗。对动物进行每日5分制神经学检查。采用计算机化定量生物测定法确定ET50(即导致一半动物出现神经功能异常所需的闭塞时间)。在每个试验中,使用双侧t检验比较对照组和治疗组的ET50值。治疗组与对照组相比ET50增加意味着HBO有有益作用;ET50降低则相反。该研究有80%的检验效能来检测双侧α=0.05时ET50中11.4分钟的差异。
试验1:HBO组的ET50为18.1±21.9分钟,对照组的ET50为22.8±25.0分钟(p>0.2)。试验2:HBO组的ET50为9.49±17.4分钟,对照组的ET50为I4.9±14.2分钟(p<0.2)。
在大鼠模型中,HBO疗法作为急性脑缺血再灌注治疗方式未显示出明显益处。