脊髓缺血再灌注损伤模型的改进及脊髓耐受缺血时限的研究

目的 建立并改进兔脊髓缺血再灌注损伤模型,研究常温下脊髓耐受缺血的时限.方法 新西兰大白兔按不同阻断时间随机分为C20、C25、C30、C40和C60 5组,每组10只.股动脉置管至腹主动脉分出左肾动脉远端并测压,肾下阻断腹主动脉20～60 min,分别于清醒即刻、再灌注6 h、24 h和48 h评定动物神经功能;再灌注48 h观察脊髓形态学变化并计数L4～L6节段前角正常运动神经元.结果 C20组在各时间点均未出现截瘫;再灌注48 h后,C25、C30和C40组分别有30%、80%和90%出现截瘫,C60组全部截瘫,各组比较差异有统计学意义(P＜0.05).再灌注48 h后,脊髓组织出现神经细胞肿胀、坏死等改变,且随阻断时间的延长,损伤程度逐渐加重;C20、C25和C30组前角正常运动神经元中位数分别为12.5、10和2,C40和C60两组均为0,各组比较差异有统计学意义(P＜0.05).结论 成功改进兔脊髓缺血再灌注损伤模型.改进后模型的脊髓耐受缺血的时限为20 min以内,为脊髓损伤的研究提供了又一判定标准.

The Reperfusion Injury Model Improvement and the Tolerance Time Investigation of Rabbit Spinal Cord Ischemia under Normothermia

Objective This study is designed to improve the rabbit model of ischemic- reperfusion injury and determine the safe clamping duration relevant to the spinal cord tolerance to ischemia at normothermia. Methods 50 New Zealand white rabbits were assigned randomly to 5 groups (Group C20, C25, C30, C40 and C60, 10 rabbits in each group) according to different clamping durations, ranging from 20 min to 60 min. The rabbits were endotracheally intubated for ventilation, and their left ear arteries were catheterized for monitoring the mean artery pressure. The spinal cord ischemia was induced by infrarenal aorta occlusion. A catheter was inserted into the aorta distal clamped site for monitoring the distal artery pressure. The neurological functional status of animal was assessed with the Tarlov scale system (0 or 1 meaning the rabbit paraplegia), at the moment of revival, 6 h, 24 h, and 48 h after the reperfusion. After last scoring, the lumbar segments of spinal cord (L4-L6) were removed for pathological examination, and the normal motor neurons of anterior horn were counted. Results Forty-eight hours after the infusion, the severe neurological impairments were not detected in the rabbits whose aorta were only clamped for 20 min (Group C20). However, the rabbits in Group C60 became totally paraplegic, and the rabbits in Group C25, C30 or C40 developed the paraplegia at 30%, 80% or 90% respectively. The median number of normal motor neuron was 12.5, 10 or 2 respectively in Group C20, C25 or C30, and 0 median number resulted in Group C40 and C60. Conclusion The rabbit model of ischemic-reperfusion injury is successfully improved, of which the safe clamping duration without spinal cord injury is not more than 20 min at normothermia.