促红细胞生成素缓解蛛网膜下腔出血后脑血管痉挛的实验研究  

Early systemic administration of erythropoietin partially relieves cerebral vasospasm after subarachnoid hemorrhage in rabbits

作　　者：黄新[1] 史继新[1] 李劲松[1] 梁捷[1] 印红霞[1] 吴波[2] 

机构地区：[1]第一军医大学临床学院南京军区南京总医院神经外科,南京210002 [2]第一军医大学临床学院南京军区南京总医院病理科,南京210002

出　　处：《中华神经医学杂志》2008年第9期899-902,共4页Chinese Journal of Neuromedicine

摘　　要：目的研究早期全身使用促红细胞生成素（EPO）对蛛网膜下腔出血（SAH）后脑血管痉挛（CVS）的作用并探索其作用机理。方法将30只雄性新西兰白兔按照随机数字表法等分为5组：（1）空白组；（2）对照组；（3）SAH组；（4）SAH＋安慰剂组；（5）SAH＋重组人促红细胞生成素（rHuEPO）组。后三组采用枕大池注血法建立兔SAH模型-注血后48h采用灌注固定法处死动物，留取基底动脉标本。通过测定基底动脉血管横截面积判断有无CVS，并用原位细胞凋亡检测法（TUNEL）检测血管内皮细胞凋亡情况。结果基底动脉横截面积测定的结果提示空白组和对照组．SAH组和SAH＋安慰剂组比较，差异无统计学意义（P〉0．05）：SAH组和SAH＋安慰剂组较空白组和对照组明显缩小，差异有统计学意义（P〈0．05）：SAH＋rHuEPO组较SAH组和SAH＋安慰剂组明显增大，差异有统计学意义（P〈0．05），但小于空白组和对照组．TUNEL染色显示SAH＋rHuEPO组血管内皮细胞凋亡程度较SAH组和SAH＋安慰剂组减轻，差异有统计学意义（P〈0．05）。结论早期全身使用rHuEPO能减少兔SAH模型基底动脉血管内皮细胞凋亡并部分缓解CVS。Objective To study the effect of early systemic administration of erythropoietin （EPO） on cerebral vasospasm （CVS） after subarachnoid hemorrhage （SAH） and explore the possible mechanism. Methods Thirty male New Zealand rabbits were randomized equally into 5 groups, namely the blank control group, saline group, SAH model group, SAH＋placebo group, and SAH＋recombinant human erythropoietin （rHuEPO） group. In the latter 3 groups, rabbit SAH model was established by autologous blood injection into the cisterna magna, and in the saline group, only normal saline was injected. Five minutes after the blood injection, the rabbits received intraperitoneal injection of rHuEPO orplacebo （EPO solvent） as indicated, followed by another 5 injections at the interval of 8 h. Forty-eight hours after the model establishment, the rabbits were sacrificed by perfusion-fixation and the basilar artery was taken. The cross-sectional area of the lumen of the basilar artery was measured to evaluate the degree of cerebral vasospasm. TUNEL assay was used to detect endothelial cell apoptosis in the basilar artery. Results The average cross-sectional area of the basilar arteries showed no significant difference between the blank control and the saline groups or between SAH and SAH＋placebo groups （P〉0.05）. The cross-sectional area of the basilar artery in SAH＋rHuEPO group was significantly greater than that in SAH group and SAH＋placebo group （P〈0.05）, but smaller than that in the blank control and saline groups. TUNEL assay revealed less intense apoptosis of the endothelial cells in SAH＋rHuEPO group than in SAH group or SAH＋placebo group （P〈0.05）. Conclusion Early systemic administration of rHuEPO can decrease endothelial cell apoptosis in the basilar artery and may partially attenuate the intensity of CVS in rabbits with SAH.

关 键 词：蛛网膜下腔山血 脑血管痉挛 促红细胞生成素 细胞凋亡 

分 类 号：R743.35[医药卫生—神经病学与精神病学]