羟乙基淀粉行急性等容血液稀释对兔脊髓缺血-再灌注损伤的保护作用

目的 探讨用羟乙基淀粉(HES130/0.4)急性等容血液稀释(ANH)对兔脊髓缺血-再灌注损伤的保护作用.方法 24只新西兰雄性大白兔,随机均分成三组:HES组,生理盐水组(NS组),对照组(C组).HES组和NS组分别用HES130/0.4和生理盐水行ANH,使红细胞压积(Hct)达30%.ANH的方法为:15 min内经股动脉恒速放出计算的血量,同时利用微量输液泵经静脉输注与放血量等量的液体(HES组)或输注3倍于放血量的液体(NS组),放血和输液速度相等,维持术中大白兔的血压和心率恒定.稳定15 min后,行肾下腹主动脉(IRA)阻闭建立脊髓缺血-再灌注损伤模型.分别于稀释前、稀释后和腹主动脉开放后采集动脉血进行血气分析.评估再灌注后4、8、12、24及48 h后肢运动功能,并于48 h处死动物取脊髓(L5)制标本行病理组织学观察.结果 再灌注后48 h.HES组和NS组动物的后肢运动功能比C组明显改善(P＜0.05或P＜0.01);HES组和NS组动物脊髓前角正常运动神经元计数比C组显著增加(P＜0.05或P＜0.01),但两组间差异无统计学意义.结论 HES130/0.4行适度ANH对脊髓缺血-再灌注损伤具有显著地保护作用.

Protective effect of acute normovolemic hemodilution with hydroxyethyl starch on rabbit spinal cord ischemia-reperfusion injury

Objective To investigate whether acute normovolemic hemodilution(ANH) with hydroxyethyl starch(HES130/0.4) could induce neuroprotective effect on spinal cord ischemia reperfusion injury in rabbits.Methods Twenty-four New Zealand male white rabbits were randomly assigned to 3 groups with 8 rabbits each.Rabbits in normal saline group (NS) and HES group were hemodiluted with normal saline or HES until Hct of 30%.Spinal cord ischemia was induced by infrarenal aortic occlusion for 15 min after hemodilution.The artery blood samples were collected for blood gas analysis.Motor function of hind limbs was assessed at 4,8,12,24 and 48 h after reperfusion.All animals were sacrificed at 48 h after reperfusion and the spinal cords (L5) were removed immediately for histopathologic study.Results Motor function scores of animals at 48 h after reperfusion in NS and HES groups were significantly highter than those in control group (P<0.05 or P<0.01).The numbers of normal neurons in the anterior spinal cord at 48 h after reperfusion of NS and HES groups were significantly more than those in control group (P<0.05 or P<0.01).There was no significant difference in the motor function scores and the numbers of normal neurons in the anterior spinal cord at 48 h after reperfusion between NS and HES group.Conclusion Moderate ANH with HES significantly attenuates the neurologic injury secondary to spinal cord ischemia and reperfusion in rabbit.