南京大学金陵医院心胸外科景华课题组（南京军区南京总医院心胸外科）关于氢气对深低温体外循环脑损伤的保护作用的研究最近被 Neurochem Res 接受。 Hydrogen-Rich Saline is Cerebroprotective in a Rat Model of Deep Hypothermic Cir.pdf 自 1950 年以后深低温停循环就在临床上开始使用，主要用与复杂心脏结构异常、主动脉弓和脑血管瘤的手术。由于可以提供比较理想的手术区域，该方法在临床上迅速被广泛采用。但长时间循环停止对神经系统可造成严重损伤，根据报道大约 25% 患者有一过性神经功能异常，有 55% 患者手术 12 周仍存在一定的神经精神异常。如果减少神经系统并发症是深低温停循环十分关注的问题。导致神经功能损伤的原因主要是系统炎症和组织缺血再灌注损伤。这些因素可以造成复杂的病理生理学改变，例如缺氧、炎症反应和自由基导致的氧化损伤等。理论上推测，抗氧化和抗炎症对深低温停循环导致的神经系统损伤有一定保护作用。 最近 Ohsawa 等发现氢气可以通过选择性抗氧化治疗组织缺血再灌注损伤，随后大量研究发现氢气对各种器官缺血再灌注损伤均具有理想的治疗作用，并发现氢气具有理想的抗炎症损伤的作用。但到目前，国际上尚未见关于氢气对深低温停循环后神经损伤的报道。本研究针试图探讨氢气对这一疾病的治疗作用。本研究采用四动脉结扎脑损伤结合低温处理，制备深低温停循环后神经损伤动物模型，采用炎症、氧化损伤、细胞凋亡、信号分子检测等技术，发现对氧化损伤、炎症和细胞凋亡等具有显著的抑制作用，说明氢气生理盐水注射对深低温停循环后神经损伤具有显著的治疗效果。该研究对拓展氢气的研究领域，具有一定意义，将来应尝试开展氢气对临床该类疾病的探索性治疗。 Hydrogen-Rich Saline is Cerebroprotective in a Rat Model of Deep Hypothermic Circulatory Arrest Neurochem Res DOI 10.1007/s11064-011-0476-4 Abstract Deep hypothermic circulatory arrest (DHCA) has been widely used in the operations involving the aortic arch and brain aneurysm since 1950s; but prolonged DHCA contributes significantly to neurological deficit which remains a major cause of postoperative morbidity and14 mortality. It has been reported that hydrogen exerts a ther- apeutic antioxidant activity by selectively reducing hydroxyl radical. In this study, DHCA treated rats developed a significant oxidative stress, inflammatory reaction and apoptosis. The administration of HRS resulted in a significant decrease in the brain injury, together with lower production of IL-1b, TNF-a, 8-OHdG and MDA as well as decreased activity of NOS while increased activity of SOD. The apoptotic index as well as the expressions of caspase-3 in brain tissue was significantly decreased after treatment. HRS administration significantly attenuated the severity of DHCA induced brain injury by mechanisms involving amelioration of oxidative stress, down-regulation of inflammatory factors and reduction of apoptosis.
标签: 总医院
