Prereperfusion flushing of ischemic territory: a therapeutic study in which histological and behavioral assessments were used to measure ischemia-reperfusion injury in rats with stroke
Prereperfusion flushing of ischemic territory: a therapeutic study in which histological and behavioral assessments were used to measure ischemia-reperfusion injury in rats with stroke
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DOI：
10.3171/jns.2002.96.2.0310
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发表时间：
2002-02-01
影响因子：
4.1
通讯作者：
Diaz, FG
中科院分区：
文献类型：
--
作者：
Ding, YC;Yao, B;Diaz, FG
Object.在缺血性中风中，缺血性危象激活了一系列创伤事件，这些事件通过再灌注而增强，并最终导致神经元变性。本研究的主要目的是研究一种通过干扰重建的血流和缺血损伤组织之间的相互作用以及通过改善局部微循环来最大限度地减少这种损伤的方法。作者使用一种新型中空细丝，在大脑中动脉（MCA）闭塞后血管再灌注前用肝素化盐水冲洗缺血区域。结果表明，在大脑中动脉闭塞2小时后再灌注48小时的大鼠中，梗死体积在统计学上显著（p < 0.001）减少（75%;从45.3 +/- 3.6%到11.4 +/-1.7%，用尼氏染色法测定）。使用银染色证实梗死和神经元变性，其显示比尼氏染色检测到的梗死显著更大的梗死（36.3%，p < 0.05）。再灌注前冲洗的长期神经保护作用也进行了评价。这是通过再灌注后28天进行的一系列运动行为任务（脚放置平行杆穿越，绳索和梯子攀爬）来确定的。发现接受冲洗程序的动物的运动缺陷显著改善（p < 0.001）。此外，在相同动物中，神经功能结局也显著改善（p < 0.001）。这些结果表明，再灌注和代谢和生化受损的组织之间的相互作用可以中断的预再灌注冲洗程序，这可能会导致减少脑损伤中风。局部冲洗和局部损伤脑的隔离再灌注的脑闭塞的机械再开放可能为中风患者提供新的治疗选择。
Object. In ischemic stroke, the ischemic crisis activates a cascade of traumatic events that are potentiated by reperfusion and eventually lead to neuronal degeneration. The primary aim of this study was to investigate a procedure that could minimize this damage by interfering with the interactions between reestablished blood flow and ischemically damaged tissue, as well as by improving regional microcirculation.Methods. Using a novel hollow filament, the authors flushed the ischemic territory with heparinized saline before vascular reperfusion after occlusion of the middle cerebral artery (MCA). The results demonstrate a statistically significant (p < 0.001) reduction in infarct volume (75%; from 45.3 +/- 3.6% to 11.4 +/- 1.7%, determined with Nissl staining) in rats in which a 2-hour MCA occlusion was followed by a 48-hour reperfusion. Infarction and neuronal degeneration were confirmed using silver staining, which revealed a significantly larger infarct (36.3%, p < 0.05) than that detected with Nissl staining. The long-term neuroprotection of the prereperfusion flushing was also evaluated. This was determined by a series of motor behavior tasks (foot placing parallel bar traversing, rope and ladder climbing) performed up to 28 days after reperfusion. Motor deficits were found to be significantly ameliorated in animals that underwent the flushing procedure (p < 0.001). In addition, neurological outcome was also improved significantly (p < 0.001) in the same animals.Conclusions. These results indicate that interaction between reperfusion and the metabolically and biochemically compromised tissue could be interrupted by the prereperfusion flushing procedure, which could lead to a reduction in brain injury from stroke. Mechanical reopening of the cerebral occlusion with local flushing and isolated reperfusion of the regionally injured brain might offer new treatment options for patients with stroke.