胰岛素治疗局灶脑缺血再灌注损伤的实验研究  

The experimental study on reperfusion injury after cerebral ischemia treated with insulin

作　　者：黄海威[1] 苏庆杰[2] 黄如训[1] 李玲[1] 肖小华[1] 

机构地区：[1]中山医科大学附属第一医院神经科,广州510080 [2]海南医学院附院神经科

出　　处：《卒中与神经疾病》2000年第3期139-141,共3页Stroke and Nervous Diseases

基　　金：美国中华医学基金会(CMB)资助!项目 (基金编号 :93-5 94)

摘　　要：目的 :观察胰岛素对脑缺血再灌注损伤的治疗作用并探讨其作用机制。方法 :制备易卒中型肾血管性高血压大鼠 ( RHRSP) ,用线栓法复制大脑中动脉阻塞 ( MCAO)模型。实验一 :造成缺血 6h再灌注 1 8h,治疗组于不同时程使用胰岛素 ,测定脑梗死体积及脑水肿的变化。实验二 :造成缺血 2 h再灌 1、3、5天 ,治疗组于再灌注后立即使用胰岛素 ,采用 TUNEL法原位标记 DNA片段 ,检测 TUNEL阳性细胞的变化。结果 :治疗组的梗死灶体积及其占全大脑体积百分比、两半球体积差值显著减小 ,TUNEL阳性细胞亦明显减少 ( P<0 .0 5)。结论 :胰岛素能减轻脑缺血再灌注损伤 ,早期用药效果更好 ,减少再灌注后细胞损伤很可能是其作用机制之一。Objective:To study the effects and mechanisms of insulin on reperfusion injury after cerebral ischemia .Methods:The middle cerebral artery occlusion (MCAO) in stroke-prone renovascular hypertension rats (RHRSP) were performed for 6 hour and reperfused for 18 hours in the first experiment The varity of the percent of infarct volume in total cerebral volume and the difference between both hemisphere were measured at 24 hours after MCAO following treated immediately and 6 hours with insulin after reperfusion. By using the terminal deoxynucleotidyl transfererase-mediated dUTP-biotin nick end labeling DNA fragments in situ (TUNEL), the irreversibly damaged neurons were detected at 1、3、5 days after reperfusion and insulin treatment in the second experiment .Results:The percent of infarct volume in total cerebral volumc and the differencc between both hcmisphere volume were significantly lower in the group with treated immediately after MCAO and reperfusion than the groups without treated ( P <0.05) .The numbers of the TUNEL positive neurons were also significantly lower in the treated groups than control groups( P <0.05).Conclusions:Insulin may have the effects in reducing reperfusion injury,which has better effects in early use. Reducing the amount of irreversibly damaged neurons after reperfusion is probably one of the mechanisms that insulin decreases reperfusion injury.

关 键 词：胰岛素 高血压 脑缺血 再灌注损伤 治疗 

分 类 号：R743.310.5[医药卫生—神经病学与精神病学]