上胸段硬膜外阻滞对蛛网膜下隙出血兔基底动脉NF-κB和COX-2表达的影响  

Effects of High Thoracic Epidural Block on the Expressions of NF-κB and Cyclooxygenase-2 in Subarachnoid hemorrhage in the Rabbits

作　　者：陈志成[1] 陈国忠[1] 吴晓智[1] 江鹤群[1] 许秀艺[1] 

机构地区：[1]福建医科大学福总临床医学院麻醉科,福州350025

出　　处：《医学综述》2012年第14期2279-2282,共4页Medical Recapitulate

摘　　要：目的探讨上胸段硬膜外阻滞(HTEB)对兔蛛网膜下隙出血(SAH)后核转录因子κB(NF-κB)和环氧化酶2(COX-2)在基底动脉表达的影响。方法切开置管法制备HTEB模型的新西兰兔30只,随机分成3组(n=10):假手术组、单纯SAH组、HTEB治疗组。HTEB治疗组硬膜外以1 mL/h的速度持续泵入0.1%罗哌卡因至实验结束。"枕大池二次注血法"(0.5 mL/kg)制成兔SAH模型,7 d后处死兔取基底动脉,光镜下观察其形态学变化,并测定基底动脉内腔面的横截面积以及动脉管壁的厚度。采用免疫组织化学方法检测基底动脉NF-κB和COX-2的表达。结果与假手术组相比,单纯SAH组、HTEB治疗组基底动脉内腔横截面积减小,管壁增厚(均P<0.05),NF-κB表达活性增高,COX-2表达增加(均P<0.01)。与单纯SAH组相比,HTEB治疗组基底动脉内腔横截面积增大,血管壁变薄(均P<0.05),NF-κB表达活性降低,COX-2表达减少(均P<0.01)。结论 HTEB可减轻兔SAH后脑血管痉挛,其机制可能与降低NF-κB和COX-2表达,抑制炎性反应有关。Objective To investigate the effects of high thoracic epidural block（HTEB） on the expressions of NF-KB and cyclooxygenase-2 （ COX-2 ） in cerebral vasospasm （CVS） after subarachnoid hemorrhage （ SAH ） in the rabbits. Methods 30 New Zealand white rabbits were randomly divided into 3 groups ： control group, SAH group, and SAH ＋ HTEB group, which received HTEB by a continuous epidural injection of 0. 1% ropivacaine 1 mL/h （group TS）. SAH model was developed by two injection of autoblood into the cistern magna（0.5 mL/kg）. Animals were killed 7 days after SAH. The changes in histological morphology of the basilar artery were observed under a light microscope. The cross-sectional area of each basilar artery lumen and arterial wall thickness were measured. The expressions of NF-KB and cyclooxygenase-2 in basilar arteries were measured by immunohistochemistry. Results Compared to the control group, vascular cross-sectional area was significantly smaller, arterial wall thickness was bigger of the SAH and SAH ＋ HTEB group （ both P 〈 0. 05 ） ; NF-KB and COX-2 expression were higher （ both P 〈 0. 01 ）. Compared to SAH group, vascular cross-sectional area of SAH ＋ HTEB group was bigger, and the arterial wall thickness was smaller（ both P 〈 0.05 ）, NF-KB and COX-2 expression were lower（ both P 〈 0.01 ）. Conclusion HTEB can attenuate CVS secondary to SAH, and the inhibition of the expression of NF-KB and COX-2.and innammatorv resnnnse may he one nf the imnnrtant mecanisma.

关 键 词：上胸段硬膜外阻滞 血管痉挛 核转录因子ΚB 环氧化酶2 

分 类 号：R743.35[医药卫生—神经病学与精神病学]