【摘要】 目的　研究卡托普利在家兔肾上主动脉阻断手术中对脊髓损伤的保护作用及其机理。方法　家兔 2 4只 ,随机分为假手术组 (A组 )、缺血组 (B组 )和卡托普利组 (C组 )。肾上阻断腹主动脉 30min后松开 ,C组于阻断前 10min静注卡托普利 0 5mg·kg-1,继以 0 15mg·kg-1·h-1持续输注至松开前 10min。连续监测颈总动脉 (BP1)和股动脉 (BP2 )平均动脉压 ,记录阻断前 10min、阻断后5min、2 0min、30min以及松开后 5min、6 0min、180min的BP1和BP2 值 ,松开后 3h观察胸 10和腰 3水平脊髓形态学变化 ,并测定脊髓组织丙二醛 (MDA)含量。结果　①B组动物阻断后的BP1显著高于阻断前 (P <0 0 5或 0 0 1) ,C组阻断后BP1较阻断前无显著变化 ;B组松开后 5、6 0、180min的血压均明显低于阻断前 ,C组松开后 6 0、180min的血压比B组明显升高 (P <0 0 5 )。②B组脊髓MDA含量明显高于A组 (P <0 0 1) ,C组与A组无显著性差异 ,但明显低于B组 (P <0 0 5 )。③B组脊髓病理变化较重 ,可见大量神经元坏死 ,C组偶有神经元坏死。结论　在家兔肾上主动脉阻断手术中使用卡托普利对脊髓损伤有较好保护作用 ,其机制与抗过氧化反应及缓解血液动力学波动有关更多还原

【Abstract】 Objective Crossclamping of aorta causes a sudden increase in systemic vascular resistance. Spinal cord may suffer ischemic injury during aortic aneurysm surgery. This study was designed to evaluate the hemodynamic and and spinal cord protective effects of captopril during suprarenal aortic crossclamping in rabbits.Methods Twenty-four albino rabbits were randomly divided into three groups :sham operation group (A),control group (B) and captopril group (C). The descending aorta was crossclamped above the level of renal artery for 30 min and then declamped.In group C a bolus of captopril 2 mg·kg -1 was given intravenously 10 min before crossclamping followed by a 0.5mg·kg -1·min -1 infusion for 30 min. The same volume of normal saline was given in other 2 groups. The carotid artery pressure(BP 1) and femoral artery pressure(BP 2) were recorded before injection, 5, 20,30min after crossclamping and 5,60,180min after declamping. Spinal cord was examined at the level of T 10 and L 3 for morphological changes and MDA content 180 min after declamping.Results 1. BP 1 increased significantly after crossclamping in group B. In group C there was no significant change in BP 1 after crossclamping. In group C there was no significant change in BP 1 after crossclamping. In group B BP after declamping was significantly lower than that before crossclamping. In group C BP at 60 and 180 min after declamping was significantly higher than that at the same intervals in group B(P<0.01). 2. MDA content of spinal cord was significantly higher in group B than that in group A and C. There was no significant difference in MDA content between group A and C. 3. In group B there were more pathological changes, greater number neuronal death could be seen and in group C neuronal death was occasional.Conclusions Captopril can alleviate the hemodynamic changes after aortic crossclamping and declamping. It has spinal cord protective effect against ischemic reperfusion injury. The possible mechanism of protection is antioxidation.更多还原