头部亚低温干预对大鼠缺血脑组织保护作用的实验研究  

Neuroprotection of mild brain hypothermia against cerebral ischemic injury

作　　者：张洪[1] 周敏[2] 章军建[1] 梅元武[3] 孙圣刚[3] 童萼塘[3] 

机构地区：[1]武汉大学中南医院神经科 武汉大学医学院脑血管病研究中心,武汉430071 [2]上海交通大学农业与生物学院 [3]华中科技大学同济医学院附属协和医院抻经内科

出　　处：《中华物理医学与康复杂志》2009年第1期12-15,共4页Chinese Journal of Physical Medicine and Rehabilitation

摘　　要：目的 研究脑缺血后即时亚低温干预对脑缺血损伤的影响.方法 将48只SD大鼠随机分为假手术组(8只)、常温(37～38℃)脑缺血组(8只)和哑低温(33～34℃)脑缺血组(32只),后者又根据亚低温持续作用时间细分为4个亚组(n=8).将常温脑缺血组和亚低温脑缺血组大鼠制成全脑缺血20 min、再灌注240 min模型.亚低温脑缺血组大鼠于脑缺血20 min时给予亚低温治疗,4个亚组亚低温持续作用时间分别为30,60,120,240 min.于脑缺血再灌注240 min后检查上述各组大鼠脑组织中一氧化氮(NO)代谢产物亚硝酸盐(NO2)、内皮素-1(ET1)、肿瘤坏死因子-α(TNF-α)和白细胞介素-1β含量;同时对各组大鼠血液中乳酸脱氢酶(LDH)、肌酸激酶(CK)和天门冬氨酸氨基转移酶(AST)及肌酸激酶脑型同工酶(CK-BB)水平进行检测.结果 常温脑缺血组大鼠脑组织中ET1、NO2、TNF-α和IL-1β水平均明显高于假手术组(P<0.01);亚低温持续作用30 min对脑缺血组织中ET1、NO2、TNF-α和IL-1β含量无明显影响(P>0.05);亚低温持续作用60～240 min可显著降低脑缺血组织中ET1、NO2、TNF-α和IL-1β水平(P<0.05或0.01).常温脑缺血组大鼠血液中LDH、AST、CK和CK-BB水平均明显高于假手术组(P<0.01);亚低温持续作用60～240 min可显著减少脑缺血大鼠血液中LDH、AST、CK和CK-BB含量(P<0.05或0.01).结论 脑缺血后即时亚低温干预能明显减轻脑缺血损伤,亚低温持续作用时间以超过1 h为宜.Objective To study the effect of mild brain hyothermia on cerebral ischemic injury. Methods Global cerebral ischemia was established by modified Pulsinelli 4-vessel occlusion model. Forty-eight Sprague-Dawley rats were divided into 4 group: a sham-operated group, a normothermia (37～38℃) ischemic group and a mild is-chemic hypothermia (31～32℃) group; the mild ischemic hypothermia was subdivided into 4 groups with the hypo-thermia lasting for 30 min, 60 min, 120 min and 240 min, respectively. After 240 rain of reperfusion following 20 min cerebral ischemia, the levels of nitric oxide products nitrite (NO2) ,endothelin-1 (ET1) , tumor necrosis fac-tor alpha (TNFα) and interleukin-1 beta (IL-1β) in brain tissue and the lactate dehydrogenase (LDH), aspartate aminotransferase(AST) , creatine kinase(CK) and its brain band isoenzyme (CK-BB) in plasma were measured. Results The levels of IL-1β,TNFα, ET1 and NO2. in brain tissue, and the amounts of LDH, AST, CK and CK-BB in serum were higher in normothermia ischemic group than those in sham-operated group (P <0.05). Mild hypother-mia lasting for 60 min to 240 min markedly decreased the levels of IL-1β, TNF-α, ET1 and NO2 in brain tissue, and the amounts of LDH, AST, CK and CK-BB in serum in normothermia ischemic group, when compared with normo-thermia ischemic group (P < 0.05 or P < 0.01). Mild hypothermia lasting for 30 min did not influence the content of IL-1β, TNF-α, ET1 and NO2 in brain tissue when compared with normothermia isehemia group (P > 0.05). Con-clusion Mild brain hypothermia post-ischemia can significantly suppress the inflammation response in ischemic brain tissue and stabilize the function of cell membrane. The best neuroprotection of mild brain hypothermia must be carried out immediately and last for more than 60 minutes.

关 键 词：藏麸塞再灌浚 委羝渥 大鼠 治疗嚣季闻塞 

分 类 号：R743.3[医药卫生—神经病学与精神病学]