环孢素对七氟醚后处理诱导脑保护作用的影响  

The effect of Cyclosporin A on sevoflurane postconditioning in focal cerebral ischemia

作　　者：夏明[1] 李伟彦[1] 董海龙[2] 熊利泽[2] 

机构地区：[1]南京军区南京总医院麻醉科,江苏南京210002 [2]第四军医大学西京医院麻醉科,陕西西安710032

出　　处：《医学研究生学报》2009年第5期452-454,459,I0001,共5页Journal of Medical Postgraduates

基　　金：国家自然科学基金资助项目(批准号:30471664)

摘　　要：目的:脑缺血损伤是围术期常见并发症,缺血后处理以及非缺血后处理如吸入麻醉药后处理可减轻脑缺血损伤。文中观察环孢素(CsA)对七氟醚后处理诱导脑保护作用的影响。方法:清洁级雄性SD大鼠50只,随机分为对照组,七氟醚后处理组,七氟醚+CsA组,七氟醚+溶剂组和CsA组,每组10只大鼠。采用大脑中动脉线栓法阻闭(MCAO)120 min后再灌注72 h,制备局灶性脑缺血模型。再灌注即刻的前20 min和后10 min给予七氟醚吸入。七氟醚后处理前给予侧脑室注射CsA。再灌注后的24、48和72 h行神经功能障碍评分(NDS),并于最后1次评分后测定脑梗死容积比。结果:缺血-再灌注72 h后,脑梗死容积比在七氟醚后处理组(0.31±0.04)、七氟醚+CsA组(0.25±0.04)、CsA组(0.30±0.03)和七氟醚+溶剂组(0.33±0.05)均明显小于对照组(0.55±0.05);七氟醚+CsA组(0.25±0.04)明显小于七氟醚后处理组和CsA组。七氟醚后处理组、七氟醚+溶剂组、七氟醚+CsA组和CsA组在NDS的各时间点明显优于对照组(P<0.05);七氟醚+CsA组明显优于七氟醚后处理组(P<0.05)。结论:mPTP关闭剂具有脑保护作用,并协同增强七氟醚后处理的脑保护作用。Objective：Ischemic cerebral injury is a common complication during perioperative period. We found that ischemic postconditioning and various non-ischemic postconditioning （e. g. inhalation anesthetics） could significantly attenuate ischemic cerebral injury. The present study was to investigate the effect of Cyclosporin A on sevoflurane postconditioning in focal cerebral ischemia. Methods ： Fifty male SD rats were randomly assigned to five groups （n = 10 each）： control group（con）, 1.0MAC group （ sevo）, 1.0MAC ＋ Cyclosporin A group（ sevo ＋ CsA） , 1.0MAC ＋ vehicle group（ sevo ＋ vehicle） and Cyelosporin A group （CsA）. All animals were subjected to right middle cerebral artery occlusion （MCAO） for 120min followed by reperfusion for 72h. The animals in sevo groups were given 1.0MACsevoflurane inhalation from 20min before to 10min after repeffusion. The animals in CsA groups were given CsA by ICV injection before sevoflurane postconditioning. The neurological deficit scores （NDS） were recorded at 24h, 48h, and 72h after repeffusion. Infarct volume percentage was determined after the last NDS assessment. Results ：The infarct volume percentage ratio of Sevo, Sevo ＋ CsA, CsA and Sevo ＋vehicle groups were 0.31 ±0.04, 0.25 ±0.04, 0.30±0.03 and 0.33 ±0.05, respectively （P 〈 0.05 among the groups） , which were significantly smaller than con group （0.55 ± 0. 05, P 〈 0.05）. The infarct volume percentage of Sevo ＋ CsA group was 0.25 ± 0.04, which was significantly different from that of Sevo group and that of CsA group （P 〈 0.05）. NDS of 24h, 48h and 72h after reperfusion in Sevo, Sevo ＋ CsA, CsA and Sevo ＋ vehicle groups were significantly higher than that in con group. Conclusion：Both Cyclosporin A and 1. OMAC sevoflurane postconditioning had significant neuroprotective effects on focal cerebral ischemia/reperfusion injury. The combined neuroprotection was superior to individual alone.

关 键 词：七氟醚 缺血-再灌注损伤 后处理 大脑 环孢素 线粒体转换孔 

分 类 号：R651.15[医药卫生—外科学]