缺血后处理与控制性低压灌注对大鼠脊髓缺血-再灌注损伤的影响  

Effects of ischemic postconditioning and controlled low-pressure reperfusion on ischemia and reperfusion-induced spinal cord injury in rats

作　　者：王丽萍[1,2] 李文献[1] 

机构地区：[1]第二军医大学长海医院麻醉科,上海200433 [2]南京军区福州总医院麻醉科,福州350025

出　　处：《第二军医大学学报》2008年第11期1341-1346,共6页Academic Journal of Second Military Medical University

摘　　要：目的:观察缺血后处理与控制性低压灌注对大鼠脊髓缺血-再灌注损伤的影响。方法:雄性SD大鼠309只,随机分为3组(n=103):对照组(Control组)、后处理组(Post-con组)和低压灌注组(LR组)。2F Fogarty球囊导管阻断胸主动脉9min合并体循环低压40mmHg(1mmHg=0.133kPa)诱导大鼠脊髓缺血。再灌注期,Control组以平均动脉压(MAP)100mmHg迅速回灌;Post-con组进行3次30s再灌/30s阻断的操作;LR组MAP维持40mmHg 3 min再升至100mmHg。监测再灌30min内脊髓相对血流量(rSCBF);测定再灌1、4、12、24h腰骶部脊髓组织超氧化物歧化酶(SOD)、过氧化氢酶(CAT)和髓过氧化物酶(MPO)的活性,及丙二醛(MDA)含量;评定大鼠后肢神经功能,观察脊髓腰段的病理改变。结果:后处理和低压灌注可改善再灌早期的高流量状态。与Control组比较,Post-con组于再灌1、4hSOD、CAT活性上调,24h内MDA含量降低,MPO活性下降(P<0.01)。LR组MDA含量虽降低(P<0.05),但SOD、CAT活性无变化;MPO活性于再灌1、4h达峰值,后逐渐下降。Post-con及LR组再灌注24h内神经功能皆明显好转,但LR组的神经行为学评分低于Post-con组。脊髓病理改变与行为学结果类似。结论:缺血后处理与控制性低压灌注皆可减轻大鼠脊髓缺血-再灌注损伤,但由于缺血后处理可提高再灌注期内源性抗氧化酶活性、减少中性粒细胞堆积而具有更强的脊髓保护作用。Objective： To investigate the effects of ischemic postconditioning and controlled low-pressure reperfusion on ischemia and reperfusion-induced spinal cord injury. Methods： Spinal cord ischemia was induced by occlusion of the descending thoracic aorta combined with maintaining systemic hypotension （40 mmHg,1 mmHg=0. 133 kPa） in rats. Rats were randomly divided into three groups （n = 103）, namely, control group, posteonditioning group （Post-con group） and low-pressure reperfusion group （LR group）. Rats in control group underwent an abrupt increase to 100 mmHg in mean arterial pressure （MAP） after reperfusion. Those in the Post-con group underwent 3 cycles of 30-second reperfusion and 30-second occlusion after 30-second full reperfusion with MAP of 100 mmHg. The MAP maintained 40 mmHg for the initial 3 min of reperfusion in the animals of the LR group, then increased to 100 mmHg. The relative spinal cord blood flow （rSCBF） was monitored simultaneously during the ischemia and 30 min after reperfusion. The activities of superoxide dismutase （SOD）, catalase （CAT） and myeloperoxidase （MPO） and malondialdehyde （MDA） content in lumbar spinal cord tissue were measured at 1,4,12 and 24 h after reperfusion,and the neurologic function of hind-limb was also evaluated at the same time. The samples of lumbar spinal cord were collected in all groups at the end of observation for histological examination. Results： Postconditioning and lowpressure reperfusion both improved the hyperperfusion after reperfusion. In Post-con group the activities of SOD and CAT was markedly increased 1 and 4 h after reperfusion （P〈0.01） compared with control group, and no marked increase in MDA and MPO was observed. The MDA in the spinal tissue of LR group was significantly lower than that of the control group （P〈 0.01） ,but no significant increases were observed in the activities of SOD and CAT. The MPO activity in LR group peaked from the 1^st to 4^th hour of reperfusion and then gradually red

关 键 词：缺血后处理 低压力 再灌注 脊髓 缺血-再灌注损伤 

分 类 号：R744[医药卫生—神经病学与精神病学]