最大长度序列脑干听觉诱发电位在头部低温治疗新生猪缺氧缺血性脑损伤中的动态变化

汪吉梅; 周文浩; 程国强; 王来栓; 蒋泽栋; 邵肖梅

doi:10.7499/j.issn.1008-8830.2013.06.020

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中国当代儿科杂志 ›› 2013, Vol. 15 ›› Issue (6) : 484-489. DOI: 10.7499/j.issn.1008-8830.2013.06.020

论著·实验研究

最大长度序列脑干听觉诱发电位在头部低温治疗新生猪缺氧缺血性脑损伤中的动态变化

汪吉梅，周文浩，程国强，王来栓，蒋泽栋，邵肖梅

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Changes in MLS-BAEP in newborn piglets with hypoxic-ischemic brain damage during selective moderate head cooling therapy

WANG Ji-Mei, ZHOU Wen-Hao, CHENG Guo-Qiang, WANG Lai-Shuang, JIANG Ze-Dong, SHAO Xiao-Mei

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摘要

目的：探讨头部低温对缺氧缺血性脑损伤（hypoxic-ischemic brain damage, HIBD）新生猪最大长度序列脑干听觉诱发电位（MLS-BAEP）的影响。方法：16头5～7 d的新生猪随机分为3组：常温正常组（n=4）、缺氧缺血（HI）组（n=6）、HI低温组（n=6）。采用双侧颈总动脉阻断和机械通气吸入6％的氧气制备HIBD模型。缺氧缺血后2 h低温组采用选择性头部低温治疗24 h。各组分别在HI前、HI后12 h、24 h、36 h、48 h、60 h、72 h、4 d、7 d、10 d、13 d、15 d进行MLSBAEP测试。结果：HI组与正常组相比，从HI后72 h开始，各波潜伏期和峰间期明显延长，第7天达到高峰，第10天开始逐渐恢复，但除Ⅰ波潜伏期外，其他指标仍明显长于正常组，直至HI后15 d仍然没有恢复正常。HI低温组Ⅲ波潜伏期及Ⅰ~Ⅲ、Ⅰ~Ⅴ峰间期在HI后 60 h 至7 d，Ⅴ波潜伏期和Ⅲ~Ⅴ峰间期在HI后72 h至7 d 均明显短于HI组（P<0.05）。结论：新生猪HI后脑干听觉通路的外周部分和中枢部分均受累，表现为MLS-BAEP的各潜伏期和峰间期的明显延长，中枢损害在HI后第7天达到高峰，第15天仍然没恢复正常。HI低温治疗可明显减轻HIBD的脑干损伤。

Abstract

OBJECTIVE: To study the effect of selective moderate head cooling therapy on maximum length sequences brainstem auditory evoked potential (MLS-BAEP) in newborn piglets with hypoxic-ischemic brain damage. METHODS: Sixteen newborn piglets aged 5-7 day old were randomly divided into three groups: normothermic control (n=4), HI (n=6) and mild hypothermia-treated (n=6). HI was induced through temporary occlusion of both carotid arteries, followed by mechanical ventilation with low concentration of oxygen (FiO2=0.06) for 30 minutes. Mild hypothermia was induced by equipment via circulating water. MLS-BAER was recorded before HI and at 12 hours, 24 hours, 36 hours, 48 hours, 60 hours, 72 hours, 4 days, 7 days, 10 days, 13 days and 15 days after HI. RESULTS: Compared with the normothermic control group, all latencies and intervals tended to increase significantly at 72 hours in the HI group and reached peak values on day 7. From day 10, all latencies and intervals tended to decrease, but apart from wave I latency, still differed significantly from those of the normothermic control group. MLS-BAER variables did not reach normal values until day 15. Ⅲ latency, Ⅰ-Ⅲ interval and Ⅰ-Ⅴ interval were significantly reduced in the hypothermia-treated group between 60 and 7 days after HI compared with the HI group (P<0.05). V latency and Ⅲ-Ⅴ interval in the hypothermia-treated group were also reduced compared with the HI group between 72 hours and 7 days after HI (P<0.05). CONCLUSIONS: Both peripheral and central auditory systems are disturbed by HI, which shows as a significant increase in MLS-BAER variables (all latencies and intervals) in newborn piglets. Involement in central brainstem auditory system reaches a peak on day 7 after injury. MLS-BAER variables still cannot reach to normal values until day 15. Selective moderate head cooling therapy can significantly reduce brainstem damage induced by HI.

导出引用

汪吉梅，周文浩，程国强，王来栓，蒋泽栋，邵肖梅. 最大长度序列脑干听觉诱发电位在头部低温治疗新生猪缺氧缺血性脑损伤中的动态变化[J]. 中国当代儿科杂志. 2013, 15(6): 484-489 https://doi.org/10.7499/j.issn.1008-8830.2013.06.020

WANG Ji-Mei, ZHOU Wen-Hao, CHENG Guo-Qiang, WANG Lai-Shuang, JIANG Ze-Dong, SHAO Xiao-Mei. Changes in MLS-BAEP in newborn piglets with hypoxic-ischemic brain damage during selective moderate head cooling therapy[J]. Chinese Journal of Contemporary Pediatrics. 2013, 15(6): 484-489 https://doi.org/10.7499/j.issn.1008-8830.2013.06.020

参考文献

［1］Suppiej A, Rizzardi E, Zanardo V, Franzoi M, Ermani M, Orzan E. Reliability of hearing screening in high-risk neonates: comparative study of otoacoustic emission, automated and conventional auditory brainstem response［J］. Clin Neurophysiol, 2007, 118(4): 869-876.

［2］Yin R, Wilkinson AR, Chen C, Brosi DM, Jiang ZD. No close correlation between brainstem auditory function and peripheral auditory threshold in preterm infants at term age［J］. Clin Neurophysiol, 2008, 119(4): 791-795.

［3］Jiang ZD, Brosi DM, Shao XM, Wilkinson AR. Sustained depression of brainstem auditory electrophysiology during the first month in term infants after perinatal asphyxia［J］. Clin Neurophysiol, 2008, 119(7): 1496-1505.

［4］李志华，陈超，蒋泽栋. 早产儿最大长度序列脑干听觉诱发电位的波形特点及发育变化［J］．中华围产医学杂志，2007,10(6):387-391.

［5］王瑾,陈超,邵肖梅,蒋泽栋.新生儿窒息后最大长度序列脑干听觉诱发电位的检查及意义［J］.中国当代儿科杂志,2008,10(2):110-114.

［6］LeBlanc MH, Qian XB, Cai ZW. The effect of glucose during ischemia on brain ATP, lactate and glutamate in piglets［J］. Biol Neonate, 1997, 72(1): 243-254.

［7］Jiang ZD, Shao XM, Wilkinson AR. Changes in BAER amplitudes after perinatal asphyxia during the neonatal period in term infants［J］. Brain Dev, 2006, 28(9): 554-559.

［8］Jiang ZD, Xu X, Brosi DM, Shao XM, Wilkinson AR. Sub-optimal function of the auditory brainstem in term neonates with transient low Apgar scores［J］. Clin Neurophysiol, 2007, 118(5): 1088-1096.

［9］Jiang ZD, Brosi DM, Wang J, Xu X, Chen GQ, Shao XM, et al.Time course of brainstem pathophysiology during first month in term infants after perinatal asphyxia, revealed by MLS BAER latencies and intervals［J］.Pediatr Res, 2003, 54(5): 680-687.

［10］Vannucci RC, Towfighi J, Vannucci SJ. Secondary energy failure after cerebral hypoxia-ischemia in the immature rat［J］. J Cereb Blood Flow Metab, 2004, 24(10): 1090-1097.

［11］Kusaka T, Ueno M, Miki T, Kuboi T, Nakamura S, Koyano K,et al. Relationship between cerebral oxygenation and phosphorylation potential during secondary energy failure in hypoxicischemic newborn piglets［J］, Pediatr Res, 2009, 65(3): 317-322.

［12］Cheng QG, Sun JQ, Wang LS, Shao XM, Zhou WH. Effects of selective head cooling on cerebral blood flow and metabolism in newborn piglets after hypoxia-ischemia［J］. Early Hum Dev, 2011, 87 (2) 109-114.

［13］王来栓，于立君，邵肖梅.低温减轻新生大鼠缺氧缺血脑细胞凋亡的作用及机制研究［J］.中国当代儿科杂志,2007,9(1):37-41.