异丙酚对兔全身热疗后脑保护机制的研究  

Protective effect of propofol on the brain following whole body hyperthermia in rabbits

作　　者：王志刚[1] 王舟[2] 赵鑫[1] 卜祥梅[1] 冯昌[1] 

机构地区：[1]山东大学第二医院麻醉科,济南250033 [2]山东大学齐鲁医院麻醉科,济南250012

出　　处：《山东大学学报（医学版）》2007年第12期1289-1293,共5页Journal of Shandong University:Health Sciences

摘　　要：目的观察异丙酚对兔全身热疗后颈内静脉球部血中乳酸(LAC)、超氧化物歧化酶(SOD)、丙二醛(MDA)以及皮质区细胞凋亡的影响,探讨异丙酚对全身热疗后急性脑损伤的保护机制。方法将新西兰大白兔随机均分为阴性对照组(A组)、热应激模型组(B组)、异丙酚低剂量5mg.kg-1.h-1泵注组(C组)、异丙酚高剂量10mg.kg-1.h-1泵注组(D组),模拟肿瘤全身高温治疗方法采用全身高温照射B、C、D组动物,维持肛温42℃2h。不同时点抽取颈内静脉球部血,测定LAC、SOD、MDA含量,48h后处死兔取脑皮质组织做含水量测定与HE染色,采用原位末端脱氧核糖核苷酸转移酶介导dUTP标记(TUNEL)法检测细胞凋亡,并将脑细胞凋亡百分数分别与体温恢复稳定时脑血SOD、MDA浓度进行直线相关性分析。结果与A组相比,B组LAC、MDA、SOD含量明显升高或下降(P<0.05或P<0.01),HE染色组织损伤明显,细胞凋亡百分数明显升高(P<0.01);与B组相比,C、D组LAC、MDA、SOD含量明显下降或升高(P<0.05或P<0.01),HE染色组织损伤减轻,细胞凋亡百分数明显降低(P<0.01),且10mg.kg-1.h-1异丙酚组脑保护作用优于5mg.kg-1.h-1组。各组脑细胞凋亡百分数与体温恢复稳定时脑血清SOD浓度之间呈负相关(r=-0.725,P<0.01),与体温恢复稳定时脑血清MDA浓度之间呈正相关(r=0.769,P<0.01)。结论异丙酚对全身热疗后脑神经细胞损伤具有保护作用,其机制可能与清除自由基进而抑制细胞凋亡有关,10mg.kg-1.h-1异丙酚组脑保护作用较好。Objective To observe the changes of LAC, SOD and MDA in blood and the apoptosis in brains of rabbits following a 42 ℃ whole body hyperthermia for 2 hours and to explore the mechanisms of propofol in protecting against acute brain injury. Methods Rabbits were randomly divided into four groups： the normal control group （A group）, the model group （B group）, the 5 mg·kg^-1 ·h^-1 propofol group （C group） and the 10 mg·kg^-1 ·h^-1 propofol group （D group）. The B, C and D groups were irradiated by a heat instrument at about 42 ℃ for2 hours. Then the levels of SOD, MDA and LAC were determined, the pathological changes of brain tissues were observed by HE coloration, the nerve cell apoptosis in the brain cortex was determined by the TUNEL method, and the relationship between nerve cell apoptosis and SOD and MDA levels at a resumed moment anus temperature was analyzed by the pertinency method. Results There were significant differences among the A, B, C and D groups in the levels of SOD, MDA and LAC, thenumber of apoptosis cells and the injury degree of HE coloration （ P 〈 0.05 or P 〈 0.01 ）, SOD： A group 〉 D group 〉 C group 〉 B group; MDA, LAC, the number of apoptosis cells, the injury degree of HE coloration：A group 〈 C group = D group 〈 B group. Conclusion Propofol is effective in protecting against CNS heat injury by clearing away the OFRs and reducing apoptosis in the brain.

关 键 词：二异丙酚 高温疗法 乳酸 超氧化物歧化酶 丙二醛 细胞凋亡 脑保护 

分 类 号：R961.1[医药卫生—药理学]