【作者】 马建军；

【导师】 闵苏；

【作者基本信息】 重庆医科大学 ， 麻醉学， 2008， 硕士

【摘要】 目的探讨不同时点家兔脑胶质细胞和皮层神经元对不同温度体外循环的反应。方法健康成年新西兰大白兔30只,雌雄不拘,体重（2.2±0.5）kg,随机分成3组（n=10）,常温组（A组,维持CPB温度36℃～37℃）、浅低温组（B组,维持CPB温度32℃～34℃）和深低温组（C组,维持CPB温度26℃～28℃）。建立开胸体外循环模型,维持Hct在20%～25%,鼓膜处监测脑温。分别于转流前即刻（T1）、转流1小时（T2）和转流2小时（T3）采集右侧颈内静脉血液标本检测血浆S100B、NSE水平。分别于T₁、T₂和T₃时点单触发刺激坐骨神经,记录体感皮层诱发电位;经颈动脉灌注固定,电镜观察皮层神经细胞超微结构。结果S100B蛋白的表达水平各组间同一时点比较差异均无统计学意义（P>0.05）,T₂、T₃时点S100B蛋白的表达值与T₁时点相比均升高,且T3时点该值高于T₂时点（P<0.05）。NSE的表达水平各组间T₂较T₃时点降低,与A组相比,B组和C组NSE的表达值降低,其中C组最低（P<0.05）;T₂、T₃时点NSE的表达值与T₁相比均升高,其中T₃时点该值高于T₂时点（P<0.05）。SCEP潜伏期:各组潜伏期T₃与T₁时点比较差异有统计学意义（P<0.05）,各时点B组和C组潜伏期长于A组（P<0.05）,C组潜伏期长于B组（P<0.05）;SCEP波幅:各组波幅T₃与T₁时点比较差异有统计学意义（P<0.05）,各时点B组和C组与A组相比,波幅值降低,且C组低于B组（P<0.05）。结论随着CPB持续时间延长兔脑神经元和胶质细胞损伤加重。不同温度体外循环状态下兔脑皮层体感诱发电位受到抑制,且随着时间延长抑制加重。更多还原

【Abstract】 Objective To investigate the response of the cerebral glial cell and neuron of rabbits to the different temperature cardiopulmonary bypass at different time point.Methods Thirty New Zealand white rabbits were randomly allocated into three groups: normothermia CPB 36℃～37℃（group A）, mild hypothermia CPB 32℃～34℃（group B）, hypothermia CPB 26℃～28℃（group C）; made the open-heart CPB model, maintaining hematocrit 20%～25%, The measurement spots of brain temperature lied at tympanum, S100B and NSE were measured by instantly before CPB （ T₁）, 1 hour after CPB（T₂）, and 2 hour after CPB （T₃）. The duration of CPB was 2 hours; Stimulating from ischiadic nerve at the time point of T₁, T₂, T₃ to induce SCEP, recording the latency and the amplitude of SCEP. The cortex was sliced for electro microscopic examination.Results The reveal level of S100B had no difference among the three groups, at the same time point, compared in interclass（P>0.05）,but there was significant difference inner the group（P<0.05）. There was difference of the reveal level of NSE among the three groups, and inner the group （P<0.05）. The latency of SCEP in group C was longer than that in group B, the latency of SCEP in group B was longer than that in group A, compared between each group, the difference is significant （P<0.05）. The Amplitude of SCEP in group C was lowest, compared between each group , the difference is significant （P<0.05）. The super microstructure of neuron and fiber after CPB had no significant difference among the three groups: the nucleus and the cytoplast of the neuron in cortex were swollen, and the heterochromatin of chromatin in nucleus was agglomerated, the perinuclear space was enlarged slightly, the electron density of the nuclear matrix was degraded.Conclusion The neuron and the glial cells of rabbits were damaged and the latency and amplitude of SCEP were inhibited during CPB, the longer the CPB duration time, the more serious the damage and the inhibition.更多还原