The study on pathological mechanism and solution method for spinal cord ischemia reperfusion injury.
The study on pathological mechanism and solution method for spinal cord ischemia reperfusion injury.
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DOI：
10.26355/eurrev_201807_15394
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发表时间：
2018-07
影响因子：
3.3
通讯作者：
Y. Fan;Min Zhu;D. Geng;K. Zhou;G. Du;Z-L Wang
中科院分区：
文献类型：
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作者：
Y. Fan;Min Zhu;D. Geng;K. Zhou;G. Du;Z-L Wang
目的探讨再灌注损伤中损伤的病理机制变化、再灌注时间相关性和顺应性，寻找血供，改善继发性损伤。材料与方法对180例主动脉阻断后立即给予生理盐水的外科手术患者进行研究。患者被分成三组。为不同的方法设计了实验条件和程序。结果缺血30min后，腰段脊髓局部血流量下降，约为基线的-77.48%，首次再灌流可部分逆转，甚至超过基线水平。再灌流后1h，血流量再次降至基础水平以下，随后下降至207.13%±38.25PU，持续3h，未见恢复。使用神经保护策略减轻这种继发性损伤需要了解这些病理生理过程。结论本研究揭示了脊髓损伤后再灌注损伤的病理机制变化与再灌注时间的相关性和顺应性，分析了脊髓损伤后继发性损伤的一些重要病理生理过程。此外，我们的研究讨论了一些已经研究过或未来可能对这种破坏性损伤进行治疗的药物疗法。
OBJECTIVE We aimed at investigating the pathological mechanism changing of injury during reperfusion injury, reperfusion time correlation and compliance, finding the blood supply and improving the secondary damage. MATERIALS AND METHODS A total of 180 patients who underwent a surgical procedure and that received normal saline intraperitoneally immediately after the patients' aortic occlusions were investigated. Patients were divided in three groups. Experimental conditions and programs were designed for various approaches. RESULTS Thirty min after the onset of ischemia, we found a decrease in the local blood flow in the lumbar spinal cord, almost -77.48% of the baseline, which was reversed partially by initial reperfusion, even exceeding the baseline level. However, 1 hour after reperfusion, the blood flow was again decreased to the level below the baseline, followed by a decline to 207.13% ± 38.25 PU for 3 h without any recovery. Attenuating this secondary damage with neuroprotective strategies requires an understanding of these pathophysiologic processes. CONCLUSIONS This study showed the pathological mechanism changes during reperfusion injury and reperfusion time correlation and compliance, and analyzed some of the important pathophysiologic processes involved in secondary damage after spinal cord injury. Moreover, our research discusses a number of pharmacologic therapies that have either been studied or have future potential for this devastating injury.