高张盐水在局灶性脑缺血再灌注损伤中的作用及其机制  

Effects of hypertonic saline against focal cerebral ischemia-reperfusion injury in rats and the mechanism

作　　者：何荣芝[1] 黄焕森[1] 田文志[1] 常业恬[2] 

机构地区：[1]广州医学院第二附属医院麻醉科,广州510260 [2]中南大学湘雅二院麻醉科,长沙410011

出　　处：《中华神经医学杂志》2009年第6期560-562,566,共4页Chinese Journal of Neuromedicine

摘　　要：目的研究高张盐水对大鼠局灶性脑缺血再灌注损伤后脑含水量、肿瘤坏死因子-α（TNF-α）含量以及脑细胞凋亡的影响，探讨高张盐水在脑缺血再灌注损伤中的作用和机制。方法健康SD雄性大鼠96只按随机数字表法分为4组，即假手术组（P组）、单纯缺血再灌注组（IR组）、7．5％高张盐水组（HS—A组）、4.2％高张盐水组（HS-B组），每组各24只。采用线栓法制作大脑中动脉缺血模型，再灌注前经股静脉分别给予7．5％NaCl（HS-A组）或4．2％NaCl（HS-B组），P组和墩组不给任何药。检查再灌注前，再灌注后30min、60min、90min时的血清Na^＋浓度。再灌注22h后，对大鼠进行神经功能缺陷评分，然后断头取脑检测左右两侧脑含水量;取缺血侧前脑皮质测TNF-α含量；取梗死灶周围脑组织，用TUNEL法检测神经元凋亡情况。结果输入高张盐水后，HS—A组和HS-B组大鼠血清Na^＋浓度明显升高．HS—A组持续到再灌注后90min，HS-B组在再灌注60min后基本恢复正常。IR组大鼠两侧脑含水量较假手术组增加，缺血侧增加更明显，比较差异有统计学意义（P〈0．05）。HS—A组和HS—B组大鼠两侧脑含水量较IR组相比明显减少，并以缺血侧减少更明显，比较差异有统计学意义（P〈0．05）；同IR组相比，HS—A组和HS—B组大鼠脑组织TNF-α含量明显降低，凋亡细胞计数明显下降，神经缺陷评分也明显下降，比较差异均有统计学意义（P〈0．05）。结论高张盐水可减少缺血再灌注后脑含水量和脑组织TNF-α含量，减轻脑细胞凋亡，改善缺血再灌注损伤后神经功能。Objective To investigate the effect ofhypertonic saline on cerebral water content, tumor necrosis factor-α （TNF-α） level and neuronal apoptosis following focal cerebral ischemia-reperfusion （IR） injury in rats and explore the mechanisms involved. Methods Ninety-six rats were randomized equally into 4 groups, namely the shame-operated group, untreated IR injury group, and 4.2% and 7.5% hypertonic saline groups （HS-A and HS-B groups, respectively）. In the latter 3 groups, cerebral ischemia was induced by middle cerebral artery occlusion for 2 h followed by administration of the corresponding treatments. Serum sodium concentration was measured at 5 min before and at 30, 60 and 90 min after the reperfusion. At 22 h ofreperfusion, the rats were sacrificed after neurological deficit evaluation, and brain edema was assessed by measuring the wet-to-dry weight ratio of the brain tissue. TNF-α expression in the ischemic brain tissue was measured by enzyme-linked immunosorbent assay （ELISA）, and the neuronal apoptosis was analyzed using TUNEL assay. Results In the saline-treated rats, serum sodium level increased significantly after saline administration, lasting for 60 min before recovering the normal levels in HS-A group and for over 90 min in HS-B group. Compared with that in the sham-operated group, the brain water content in rats of the IR group increased in both of the hemispheres, but more obviously in the ischemic hemisphere. In the two saline-treated groups, the water content decreased significantly in the bilateral hemispheres, which was especially obvious in the ischemic hemisphere; administration of 7.5% saline resulted in greater water content reduction in the ischemic hemisphere than 4.2% saline. Compared with the IR group, the two saline-treated groups showed significant reduction in TNF-α levels and apoptotic cells in the brain along with decreased neurological deficits. Conclusion Hypertonic saline can ameliorate cerebral focal IR injury by decreasing the cerebral water content, TNF-α l

关 键 词：缺血再灌注 高张盐水 含水量 肿瘤坏死因子-Α 细胞凋亡 

分 类 号：R686[医药卫生—骨科学]