New determinants for casual peripheral mechanism of neurogenic lung edema in subarachnoid hemorrhage due to ischemic degeneration of vagal nerve, kidney and lung circuitry. Experimental study

Abstract Purpose: To evaluate whether there is a relationship between renal artery vasospasm related low glomerular density or degeneration and neurogenic lung edema (NLE) following subarachnoid hemorrhage. Methods: This study was conducted on 26 rabbits. A control group was formed of five animals, a SHAM group of 5 to which saline and a study group (n=16) injected with homologous blood into the sylvian cisterna. Numbers of degenerated axons of renal branches of vagal nerves, atrophic glomerulus numbers and NLE scores were recorded. Results: Important vagal degeneration, severe renal artery vasospasm, intrarenal hemorrhage and glomerular atrophy observed in high score NLE detected animals. The mean degenerated axon density of vagal nerves (n/mm2), atrophic glomerulus density (n/mm3) and NLE scores of control, SHAM and study groups were estimated as 2.40±1.82, 2.20±1.30, 1.80±1.10, 8.00±2.24, 8.80±2.39, 4.40±1.14 and 154.38±13.61, 34.69±2.68 and 12.19±1.97 consecutively. Degenerated vagal axon, atrophic glomerulus and NLE scores are higher in study group than other groups and the differences are statistically meaningful (p

摘要 目的：评估蛛网膜下腔出血（subarachnoid hemorrhage）后，与肾动脉痉挛（renal artery vasospasm）相关的低肾小球密度或退行性变，是否与神经源性肺水肿（neurogenic lung edema, NLE）存在关联。
方法：本研究共纳入26只家兔。设置对照组（5只）、假手术组（SHAM group，5只，仅给予生理盐水处理）以及实验组（study group，n=16，向外侧裂池（sylvian cisterna）注射同源血液）。记录迷走神经（vagal nerves）肾支的变性轴突数量、萎缩肾小球数量及NLE评分。
结果：在NLE评分较高的受试动物中，可观察到显著的迷走神经变性、严重肾动脉痉挛、肾内出血及肾小球萎缩。对照组、假手术组与实验组的迷走神经变性轴突密度（单位：n/mm²）、萎缩肾小球密度（单位：n/mm³）及NLE评分依次为：2.40±1.82、2.20±1.30、1.80±1.10；8.00±2.24、8.80±2.39、4.40±1.14；154.38±13.61、34.69±2.68、12.19±1.97。实验组的迷走神经变性轴突密度、萎缩肾小球密度及NLE评分均高于其余两组，且差异具有统计学意义（p