Local saline infusion into ischemic territory induces regional brain cooling neuroprotection in rats with transient middle cerebral artery occlusion
Local saline infusion into ischemic territory induces regional brain cooling neuroprotection in rats with transient middle cerebral artery occlusion
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DOI：
10.1227/01.neu.0000114513.96704.29
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发表时间：
2004-04-01
期刊：
影响因子：
4.8
通讯作者：
Diaz, FG
中科院分区：
文献类型：
--
作者：
Ding, YC;Li, L;Diaz, FG
目的：低温的神经保护作用早已被认识。目前通过全身表面冷却诱导的用于中风治疗的低温的使用主要由于管理问题和严重的副作用（例如，肺炎）。本研究的目的是确定向缺血区域局部注入生理盐水是否可以诱导局部脑冷却和神经保护。方法：采用一种新的手术方法，用空心细丝阻断大鼠大脑中动脉3小时，并局部注入大脑中动脉。用6 ml冷生理盐水供应区域（20 ℃）处理10分钟后再灌注。冷生理盐水输注迅速且显著地将大脑皮层的温度从37.2 +/- 0.1 ℃降低到33.4 +/-0.4 ℃，将纹状体的温度从37.5 +/-0.1 ℃降低到33.4 +/-0.4 ℃。0.2至33.9 +/-0.4 ℃。再灌注后60分钟仍有明显的低温。再灌注48小时后，梗死体积明显减少（约90%）（P < 0.01）。在通过股动脉全身接受等量冷生理盐水的缺血大鼠中，仅在大脑皮层（35.3 +/-0.2 ℃）诱导轻度低温，并在5分钟内恢复正常。在该组或局部温盐水输注或不输注的缺血组中未观察到梗死体积显著减少。再灌注14天后，脑冷灌注显著改善缺血大鼠的运动行为（P< 0.01）。这种改善持续到28天后reperfusion.CONCLUSION：局部预灌注输液有效地诱导低温和改善脑损伤中风。临床上，该手术可用于急性卒中治疗，可能与动脉内溶栓或通过微导管机械破坏凝块联合使用。
OBJECTIVE: The neuroprotective effect of hypothermia has long been recognized. Use of hypothermia for stroke therapy, which is currently being induced by whole-body surfact cooling, has been limited primarily because of management problems and severe side effects (e.g., pneumonia). The goal of this study was to determine whether local infusion of saline into ischemic territory could induce regional brain cooling and neuroprotection.METHODS: A novel procedure was used to block, the middle cerebral artery of rats for 3 hours with a hollow filament and locally infuse the middle cerebral artery-supplied territory with 6 ml cold saline (20degreesC) for 10 minutes before reperfusion.RESULTS: The cold saline infusion rapidly and significantly reduced temperature in cerebral cortex from 37.2 +/- 0.1 to 33.4 +/- 0.4degreesC and in striatum from 37.5 +/- 0.2 to 33.9 +/- 0.4degreesC. The significant hypothermia remained for up to 60 minutes after reperfusion. Significant (P < 0.01) reductions in infarct volume (approximately 90%) were evident after 48 hours of reperfusion. In ischemic rats that received the same amount of cold saline systemically through a femoral artery, a mild hypothermia was induced only in the cerebral cortex (35.3 +/- 0.2degreesC) and returned to normal within 5 minutes. No significant reductions in infarct volume were observed in this group or in the ischemic group with local warm saline infusion or without infusion. Furthermore, brain-cooling infusion significantly (P< 0.01) improved motor behaviour in ischemic rats after 14 days of reperfusion. This improvement continued for up to 28 days after reperfusion.CONCLUSION: Local preperfusion infusion effectively induced hypothermia and ameliorated brain injury from stroke. Clinically, this procedure could be used in acute stroke treatment, possibly in combination with intra-arterial thrombolysis or mechanical disruption of clot by means of a microcatheter.