心钠素对耳蜗缺血再灌注损伤的影响  

Atrial natriuretic factor′s effects on the reperfusion process after cochlea ischemia

作　　者：熊巍[1] 邱建华[1] 林颖[1] 乔莉[1] 刘顺利[1] 

机构地区：[1]第四军医大学西京医院全军耳鼻咽喉专科中心,西安710032

出　　处：《中华耳鼻咽喉头颈外科杂志》2006年第4期293-296,共4页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

基　　金：国家自然科学基金资助(39200133)

摘　　要：目的观察心钠素对豚鼠耳蜗缺血再灌注损伤的影响。方法将豚鼠分为4组:实验组(A1、B1)及对照组(A2、B2)。采用造血栓后溶栓的方法制备耳蜗缺血再灌注模型。实验组A1在建模前10 m in静脉注射心钠素,实验组B1在再灌注即刻静脉注射心钠素,对照组(A2、B2)在相应时间静脉注射等量生理盐水。实验过程中采用激光多普勒血流量仪监测耳蜗血流量(cochlear b loodflow,CoBF)并测定豚鼠听性脑干反应(aud itory brainstem response,ABR)值。结果缺血前实验组A1的CoBF较对照组A2高,再灌注后至实验结束,2组CoBF值未见明显差别。实验组B1和对照组B2用药前的CoBF无明显差别,再灌注后对照组B2恢复到实验开始时的70%左右,而实验组B1恢复到实验开始时相同水平。缺血前4组听阈差异无统计学意义。缺血30 m in时,实验组A1的听阈较对照组A2低(t=7.761,P<0.05)。实验组B1和对照组B2听阈差异无统计学意义。再灌注30 m in和60 m in时,实验组A1与对照组A2差异无统计学意义。实验组B1比对照组B2显著降低(t值分别为9.846和19.242,P值均<0.05)。结论缺血再灌注后即刻应用心钠素,可以减轻耳蜗的缺血再灌注损伤,可以在增加耳蜗血流的同时降低听反应阈。为临床内耳微循环障碍疾病提供一种新的药物治疗方法。Objective To investigate the effects of atrial natriuretic peptide（ANP） on ischemia and reperfusion cochlea in guinea pigs. Methods The guinea pigs were randomly allocated into four groups： experiment groups（A1 and B1 ） and control groups （A2 and B2）. Cochlear ischemia and reperfusion was induced by thrombus and thrombolysis method. In experiment group A1, ANP was administered 10 rain before the ischemic insult. In experiment group B1, ANP was administered at the beginning of reperfusion. In control groups, instead of ANP, normal sodium was injected. The blood flow of cochlea （CoBF） was monitored continuously with laser Doppler flow meter and the threshold of auditory brainstem response （ABR） was measured. Results Before the induction of ischemia, the CoBF of experiment group A1 was higher than that of the control group A2. From the reperfusion moment to the end of the experiment, there was no difference between the CoBF of the two groups. In B1 and B2 groups, no difference could be seen between the two groups before the induction of ischemia. After reperfusion, the blood flow of control group B2 recovered to 70% of the base level, while the CoBF of experiment group B1 restored to almost the same level of the beginning. Before ischemia, the ABR threshold of the four groups had no difference. At 30 rain of ischemia, the threshold of experiment group A1 was lower than that of control group A2. And there was no difference in experiment group B1 and control group B2. At 30 min and 60 rain of reperfusion, the threshold of experiment group B1 was siguificantly lower than that of control group B2. No difference could be seen between experiment group A1 and control group A2. Conclusions Administration of ANP at the beginning of reperfusion protects the cochlea from ischemia and reperfusion injury. The administration can not only increase the CoBF, but lower the ABR threshold.

关 键 词：心钠素 耳蜗 再灌注损伤 诱发电位 听觉 脑干 

分 类 号：R764[医药卫生—耳鼻咽喉科]