Isoflurane Prevents Neurocognitive Dysfunction After Cardiopulmonary Bypass in Rats
Isoflurane Prevents Neurocognitive Dysfunction After Cardiopulmonary Bypass in Rats
复制标题
异氟烷可预防大鼠心肺搭桥术后的神经认知功能障碍
DOI：
10.1053/j.jvca.2012.09.005
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发表时间：
2013-06-01
影响因子：
2.8
通讯作者：
Su, Diansan
中科院分区：
文献类型：
--
作者：
Li, Wen;Zheng, Beijie;Su, Diansan
目的：体外循环（CPB）心脏手术后认知功能障碍的发生率较高。来自大鼠CPB模型的现有数据是相互矛盾的。然而，没有一项研究旨在探讨异氟醚（所有这些研究的主要麻醉剂）在CPB后神经认知功能障碍中的作用。异氟醚具有神经保护作用，因此作者推测异氟醚可以预防CPB后大鼠的神经认知功能障碍。设计：前瞻性干预性研究。环境：大学研究实验室。实验对象：雄性sd大鼠。干预措施：雄性Sprague-Dawley大鼠分为5组：异氟醚CPB组，异氟醚麻醉后进行60分钟常温CPB；水合氯醛CPB组，用水合氯醛麻醉，进行60分钟的恒温CPB；异氟醚假手术组只插管，麻醉时间相同，不加CPB；水合氯醛假手术组只插管，麻醉时间相同，不加CPB；而在幼稚组，动物没有接受任何治疗。在CPB后第4 ~ 6天（短期）和第31 ~ 33天（长期）测量各组大鼠的神经认知功能。行为试验结束后，处死动物，取脑测定乙酰胆碱酯酶（AChE）和胆碱乙酰转移酶蛋白水平。实验结果：水合氯醛麻醉大鼠CPB后短期（CPB后4 ~ 6天）学习记忆功能受损。当使用异氟醚时，CPB后的学习和记忆没有变化。CPB后未见长期（术后31-33天）神经认知改变。无论是否行CPB，异氟醚麻醉后乙酰胆碱酯酶均显著降低。结论：异氟醚可预防CPB所致的神经认知功能障碍，其机制可能涉及脑胆碱能系统。(C) 2013爱思唯尔公司版权所有。
Objective: Postoperative cognitive dysfunction occurs frequently after cardiac surgeries with cardiopulmonary bypass (CPB). Available data from rat CPB models are conflicting. However, none of them was designed to investigate the role of isoflurane (the main anesthetic in all of these studies) in the neurocognitive dysfunction after CPB. Isoflurane has documented neuroprotective effects so the present authors hypothesized that isoflurane prevents the neurocognitive dysfunction in rats after CPB.Design: A prospective, interventional study.Setting: A university research laboratory.Participants: Male Sprague-Dawley rats.Interventions: Male Sprague-Dawley rats were divided into 5 groups: the isoflurane CPB group, the animals were anesthetized with isoflurane and underwent 60 minutes of normothermic CPB; the chloral hydrate CPB group, the animals were anesthetized with chloral hydrate and underwent 60 minutes of normothermic CPB; the isoflurane sham group, the animals were subjected only to cannulation and the same duration of anesthesia but no CPB; the chloral hydrate sham group, the animals received only cannulation and the same duration of anesthesia but no CPB; and the naive group, the animals received no treatment. The neurocognitive function of all rats was measured on days 4 to 6 (short-term) and 31 to 33 after CPB (long-term). After the behavior tests, the animals were sacrificed, and the brain was harvested for the measurement of acetylcholinesterase (AChE) and choline acetyltransferase protein levels.Measurements and Main Results: Short-term (days 4-6 after CPB) learning and memory were impaired after CPB when the animals were anesthetized with chloral hydrate. When isoflurane was used, the learning and memory did not change after CPB. No long-term (days 31-33 after CPB) neurocognitive changes were found after CPB. AChE decreased significantly after isoflurane anesthesia regardless of whether CPB was performed.Conclusions: Isoflurane prevented the neurocognitive dysfunction induced by CPB, which might involve the cerebral cholinergic system. (C) 2013 Elsevier Inc. All rights reserved.