缺血前皮下注射硫酸镁在短暂性脑缺血中的神经保护作用

Neuroprotective effects of preischemia subcutaneous magnesium sulfate in transient cerebral ischemia.

作者信息

Sirin B H, Coşkun E, Yilik L, Ortaç R, Sirin H, Tetik C

机构信息

Department of Cardiovascular Surgery, Pamukkale University Hospital, Denizli, Turkey.

出版信息

Eur J Cardiothorac Surg. 1998 Jul;14(1):82-8. doi: 10.1016/s1010-7940(98)00140-7.

DOI:10.1016/s1010-7940(98)00140-7

PMID:9726620

Abstract

OBJECTIVE

Neurological injury due to transient cerebral ischemia is a potential complication of cardiovascular surgery. The neuroprotective effect of magnesium, when given subcutaneously before the ischemia, was assessed in a rat model of transient global cerebral ischemia.

METHODS

Thirty-six male Wistar albino rats were included to this randomized, controlled, prospective study. In 24 animals, ischemia was induced with four-vessel occlusion technique with the duration of 15 min. MgSO4 was given 600 mg/kg subcutaneously 48 h before the procedure in group 1 (n = 12). Similar volume of saline solution was used in animals of control group (group 2, n = 12). The animals in group 3 (sham group, n = 12) were anesthetized and subjected to operative dissections without vascular occlusion. Physiological parameters and somatosensory evoked-potentials (SEP) were monitored in animals before ischemia, during ischemia and in the first 30 min of reperfusion. Their neurological outcome had been clinically evaluated and scored up to 4 days postischemia. The intergroup differences were compared. Then the animals were sacrificed and their brains were processed for histopathological examination.

RESULTS

In group 3, SEP amplitudes did not change during the procedures, and all animals recovered without neurologic deficits. At the end of ischemic period, the average amplitude was reduced to 5 +/- 3% of the baseline in all ischemic animals. This was followed by a gradual return to 87 +/- 10% and 83 +/- 8% of the initial amplitude after 30 min of reperfusion in group 1 and group 2, respectively (P > 0.05). The average neurological score was significantly higher in group 1 than in group 2 at 48, 72 and 96 h after the ischemic insult (P < 0.05). Histological observations were clearly correlated with the neurological findings.

CONCLUSION

The results suggest that subcutaneous MgSO4 reduces cerebral injury and preserves neurologic function when given two days before the transient global ischemia in rats.

摘要

目的

短暂性脑缺血所致神经损伤是心血管手术的一种潜在并发症。本研究在大鼠全脑短暂性缺血模型中评估了缺血前皮下注射镁的神经保护作用。

方法

36只雄性Wistar白化大鼠纳入本随机、对照、前瞻性研究。24只动物采用四血管闭塞技术诱导缺血，持续15分钟。第1组（n = 12）在手术前48小时皮下注射600 mg/kg硫酸镁。对照组（第2组，n = 12）动物注射等量生理盐水。第3组（假手术组，n = 12）动物麻醉后进行手术解剖，但不进行血管闭塞。在动物缺血前、缺血期间和再灌注的前30分钟监测生理参数和体感诱发电位（SEP）。对其神经功能结局进行临床评估，并在缺血后4天内评分。比较组间差异。然后处死动物，取脑进行组织病理学检查。

结果

第3组动物在手术过程中SEP波幅未发生变化，所有动物均无神经功能缺损恢复。在缺血期末，所有缺血动物的平均波幅降至基线的5±3%。随后，第1组和第2组在再灌注30分钟后波幅分别逐渐恢复至初始波幅的87±10%和83±8%（P>0.05）。缺血损伤后48、72和96小时，第1组的平均神经评分显著高于第2组（P<0.05）。组织学观察结果与神经学发现明显相关。