摘要
目的 比较异丙酚和硫喷妥钠对大脑局灶性缺血 /再灌注损伤中血脑屏障 (BBB)通透性变化及神经病理学的影响。方法 6 0只成年大鼠随机分为 5组 ,均采用尼龙线栓堵左侧大脑中动脉的方法建立暂时性局灶性脑缺血模型 :对照组 (MC组 )不用全麻药 ;异丙酚预防组 (MP1组 )及硫喷妥钠预防组 (MT1组 ) ,在制作大脑中动脉闭塞模型前 30min分别静脉注射异丙酚 2 0mg/kg或 2 5 %硫喷妥钠溶液 40mg/kg ,继之以异丙酚 5 0～ 6 0mg·kg 1·h 1或硫喷妥钠 10 0～ 12 0mg·kg 1·h 1的速率持续静脉输注以维持EEG呈爆发抑制 ,直至再灌注前停药 ;异丙酚治疗组 (MP2组 )及硫喷妥钠治疗组 (MT2组 )分别于再灌注开始时静脉输注异丙酚或硫喷妥钠 ,剂量、用法同预防组 ,并持续至实验结束。结果 MP1组及MP2组脑蓝染情况及光镜观察结果与对照组无明显差别 ;MT1组及MT2组脑蓝染程度、范围均减轻 ,光镜观察见缺血性改变的神经元数量减少 ,其中MT1组BBB通透性改变及脑组织缺血性损伤最轻。结论 暂时性局灶性脑缺血性损伤时在缺血过程中及再灌注后应用产生脑电图爆发抑制剂量的硫喷妥钠可以减轻脑损伤 ,缺血前开始用效果更好 ;异丙酚不能使脑缺血 /再灌注损伤改善。
Objective To observe the effects of propofol or thiopental on the changes of blood brain barrier (BBB) permeability in focal cerebral ischemia Methods Focal cerebral ischemia model was induced with occluding the middle cerebral artery (MCA) Sixty adult male SD rats were divided randomly into 5 groups: control group(group MC): without any anesthetics; propofol pretreated group (group MP1) or thiopental pretreated group (group MT1): intravenous bolus of propofol 20mg/kg or thiopental 40mg/kg, followed by intravenous infusion of propofol or thiopental at rate of 50 60 mg·kg 1 ·h 1 or 100 120 mg·kg 1 ·h 1 ,respectively ,to achieve and maintain the EEG burst suppression 30 min before MCA occlusion until the beginning of reperfusion; propofol therapy group (group MP2) or thiopental therapy group (group MT2): from the beginning to the end of the reperfusion , propofol or thiopental was administered at the same dose as group MP1 or group MT1; Blood pressure, P ET CO 2, ECG and EEG were monitored throughout the experiment Rectal temperature was maintained between 37 5℃ and 38 5℃ At the end of the experiment, after intravenous bolus of 2% evans blue dye(EB) 3ml/kg, the brain was taken out to check out the extends and areas of EB staining on the surface and standardized serial coronal sections of the brain ,under the optical microscope and electromicroscope Results 1 Both propofol groups did not alleviate BBB permeability changes and cerebral damage 2 Cerebral injury was most slightly in group MT1 3 BBB permeability and brain injury in group MT2 were slighter than those in group MC and MP1, MP2 Conclusions Thiopental at the dose maintaining EEG burst suppressioncan can reduce the brain injury induced with ischemia and reperfusion, with the better protective effects following the prophylactic administration Propofol at that dose can not improve the cerebral ischemic reperfusion injury
出处
《中华麻醉学杂志》
CSCD
北大核心
2000年第11期687-690,共4页
Chinese Journal of Anesthesiology
