| Objective:this study aims to increase slowly intracranial pressure method to establish the pig brain dead model and a methylprednisolone sodium succinate for Injection intervention treatment, Watch the indexes brain death of pig which include serum IL-1, IL-6, TNF alpha level and heart tissue IL-1mRNA, IL-6mRNA and TNF alpha mRNA expressions, myocardial tissue water content and cardiotonic drug dosage of amount, electron microscope ultrastructural changes of heart and discusses the protection of methylprednisolone sodium succinate for Injection to the brain dead heart donor of pig.Methods:12pigs of healthy banna xiaoerzhu were divided randomly into two groups (n=6), the control group (group A) and the experimental group (group B). Both groups are done intravenous general anesthesia trachea intubation lookahead, then breathing machine helps to breathe, internal jugular vein catheterization, Foley catheter was placed after craniotomy and Foley balloon catheter line intracranial pressure, then brain death model was set up and maintained1Oh, the control group was limited to import fluid and dopamine and dobutamine (10-20mg/Kg) maintain CVP for6-10cmH2O, MAP for60mmHg. If the collapse in urine disease applicate arginine vasopressin, all of the above and time and urine output there are detailed records. The animals in the brain death model establishment half an hour before the intravenous armour spilled nylon succinic acid sodium15mg/Kg, application ling fluid and dopamine and a dobutamine maintain for6-10CVP cmH2O, MAP for60mmHg. If the collapse in urine disease application arginine vasopressin, quantity and time and urine output also detailed records. Both groups in the experimental process in the drug intervention outside, other are the same. Application of intracranial pressure slowly discontinuous method to establish the brain dead model, through the respiration, circulation support experimental animal brain dead state l0hours, after10hours remove respiration, circulation support. Both groups were in experimental animals brain death within l0h took arterial blood15ml saved (every2h/times), at the end of experiment took ventricular myocardial tissue3piece of each about1g respectively saved.Results:1. Through the slow intracranial pressure method to establish the pig brain dead model,12pigs intraoperative the success rate for100%, postoperative l0h model80%survival rate, made in the process of two death model, the end of10pig (two group of each five only). The reason for failure in1May because brain dead experimental process the midbrain tissue destruction serious cause death,1case with another frequent in the experimental process of ventricular fibrillation rescue invalid death.2. cardiotonic drug usage:the control group through the slow intracranial pressure method to establish the pig brain death model, with cardiac function in the late fall gradually, mean arterial pressure (MAP) reduce, central vein pressure (CVP) increase, a low blood pressure state, need blood vessels activity dopamine drugs and dobutamine to maintain the basic blood pressure. In a group with a methylprednisolone sodium succinate for Injection intervention, mean arterial pressure (MAP), central vein pressure (CVP) than the control group improved obviously and dopamine dosage for significantly less. It is show that methylprednisolone sodium succinate for Injection is have the role of improving heart function obviously after pig brain death heart.3. Blood inflammation factors change:in the control group and the two groups of serum IL-1, IL-6, TNF alpha level change is having a significant difference (P<0.05). Serum IL-1, IL-6, TNF alpha level of the experimental group is decreased more than the control group.4. The heart tissue inflammation factors of mRNA expression:in the control group and the two groups of heart tissue IL-1mRNA, IL-6mRNA and TNF alpha mRNA expression level of change is significant difference (P<0.05). The control group heart tissue inflammation factors are the expression of the mRNA reduced significantly.5. Myocardial tissue water content:in the control group and the two groups of heart tissue myocardial water content level change with significant difference (P<0.05). The control group myocardial tissue moisture content is reduced.6. Myocardial by electron microscopy showed:the control group myocardial cell performance for serious mitochondria empty bubble degeneration and myocardial fiber breakage, myocardial interstitial severe swelling area of the mitochondria are disintegrating, muscle plasma nets expansion; The myocardial cell performance for mild mitochondria empty bubble degeneration and heart muscle fiber fracture, myocardial interstitial edema ease, part of mitochondria apart. 7. Myocardial tissue by electron microscopy observation:the control group between myocardial edema, part of myocardial fiber particles degeneration, myocardial interstitial blood vessels are contracting, muscle fiber denaturation watery cytoplasm and muscle the original fiber color becomes lighter, inflammatory cell, local visible bleeding. The myocardial interstitial edema, myocardial fiber particles degeneration ease, inflammatory cell decreases.Conclusion:1. The application of the continuous improvement of intracranial pressure slowly law and monitoring the pig brain dead model, the success rate and repeatability high, more in line with the development of clinical brain death process, the effective breathing and circulation support, brain death can maintain stable state.2. Brain death can lead to pig brain dead myocardial tissue damage, with brain death the extension of time can appear morphological change.3. Brain death can lead to pig serum inflammation factors IL-1, IL-6, TNF alpha release increase, myocardial tissue IL-1mRNA, IL-6mRNA and TNF alpha mRNA expression increases, use a spilled nylon succinic acid sodium intervention inflammation factors IL-after1, IL-6, TNF alpha release reduce, myocardial tissue IL-1mRNA, IL-6mRNA and TNF alpha mRNA expression reduced.4. Pour a nylon succinic acid sodium brain death to the pig myocardial injury has certain protective effect. |
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