卡托普利局部灌注对脊髓缺血损伤的保护作用

目的观察局部灌注卡托普利低温溶液对阻断兔主动脉致脊髓缺血损伤的保护作用。方法 3 2只成年新西兰白兔随机分成假手术组 (A组 )、缺血对照组 (B组 )、低温生理盐水局部灌注组 (C组 )和低温生理盐水 +卡托普利 (4mg/kg)局部灌注组 (D组 ) ,每组 8只。阻断肾动脉水平和主动脉分叉上方的腹主动脉上下两端 40min ,建立兔脊髓缺血损伤模型 ,经主动脉阻断段灌注保护液 ,观察 4组动物的血流动力学指标、再灌注后后肢神经功能Tarlov评分和脊髓组织病理学改变。结果 4组动物的心率、血压均无显著性差异 ;B组 8只兔子发生瘫痪 ,C组 3只瘫痪 ,D组仅 1只瘫痪 ,3组间的差异有显著性意义 (P <0 .0 5 ) ;光镜下 ,C、D组兔子脊髓前角正常神经细胞数较B组明显增多 (P <0 .0 1)。结论卡托普利低温溶液局部灌注对脊髓缺血损伤有较好的保护作用。

Protective effect of regional captopril infusion on ischemia-reperfusion injury of spinal cord

Objective To investigate the effect of regional captopril infusion on ischemia-reperfusion (I-R) injury of spinal cord in rabbits. Methods 32 rabbits were divided randomly into four groups, the group A (sham operated, no I-R injury), the group B (control group, only with I-R injury), the group C (I-R injury + intra-aortic infusion of hypothermic normal saline), and the group D (I-R injury + infusion of normal saline plus 4mg/kg captopril). Spinal cord ischemia was induced by clamping the aorta both below the left renal artery and above the aortic bifurcation. Hemodynamic data were measured in every group. The spinal cord function was assessed 24, 48 and 96 hours after aortic declamping according to Tarlov's Scale. Spinal cords were harvested for histological analysis. Results There were no significant differences in blood pressure and heart rate among four groups. The neurological status in the groups C and D was significantly superior to that of the group B ( P<0.01). In the group B, all animals were paraplegic with Tarlov's Scale of 0 or 1. Three of 8 animals in the group C were paraplegic with Tarlov's Scale of 0 or 1, and only one animal in the group D. Compared to the group B, there were more normal neurons in the anterior horn of spinal cords in the groups C and D ( P<0.01). Conclusion Regional infusion of hypothermic normal saline contained captopril can provide sufficient spinal cord protection against ischemia.