辛伐他汀经副半奇静脉逆灌注对猪脊髓缺血再灌注损伤的保护作用  

The influence of simvastatin combined with the accessory hemiazygos vein retrograde on IL-1 ,BDNF and GDNF in swines＇ischemia/reperfusion injury

作　　者：刘真苓 郑少忆[1] 朱平[1] 富旗 李小辉[1] 齐霄[1] 王世强[1] 庄建[1] 陈寄梅[1] 

机构地区：[1]广东省心血管病研究所广东省人民医院心外科广东省医学科学院,广州510080

出　　处：《中华胸心血管外科杂志》2014年第5期300-303,共4页Chinese Journal of Thoracic and Cardiovascular Surgery

基　　金：中国科技部国际合作项目（2008DFA31140,2010DFA32660）;中国科技支撑计划项目（2011BAI11B22）;广东省科技计划项目（00293192210305022）

摘　　要：目的探讨辛伐他汀在脊髓缺血再灌注损伤中的保护作用及其可能的作用机制。方法24只健康成年西藏小型猪，雌雄不拘，体质量20～30kg。随机分为假手术组、对照组和实验组，每组8只。胸主动脉阻断法建立脊髓缺血再灌注损伤模型，分离副半奇静脉，远心端结扎，近心端插管。术中记录心电图、近心端血压、远心端血压、心率、鼻咽温。缺血过程中，对照组副半奇静脉逆灌乳酸林格钠液1000ml（860ml／h），实验组副半奇静脉逆灌辛伐他汀溶液1000ml（0．25mg／kg，860ml／h）。术后继续饲养，实验组连续30天口服辛伐他汀片剂80mg／天。术后30天，收集L2～IJ5及骶段脊髓标本及血清，行组织形态学、电镜及Elisa检测。结果与对照组相比，实验组核溶解程度较轻，神经元结构相对完整，存活数量较多，白细胞介素-1（IL-1）表达降低，脑源性神经营养因子（BDNF）和胶质细胞源神经营养因子（GDNF）表达增加。结论术中和术后持续使用辛伐他汀可明显促进脊髓缺血再灌注损伤后的神经元恢复，该神经保护作用可能与降低炎性反应，增加BDNF、GDNF表达有关。Objective Inspired by the simvastatin＇ s brain protective effect, we seek to investigate its protective effect and mechanism of the spinal cord ischemia/reperfusion injury. Methods 24 healthy adult tibet mini-pigs of either sex, weigh- ted 20 - 30 kg, were randomly divided into 3 groups, 8 pigs in each group. Group A, Sham operation group. Group B, Control group, i.e. the simple Ischemia/Reperfusion group. Group C, simvastatin experimental group. Creating the models of spinal cord Ischemia/Reperfusion by thoracic aorta occlusion（70 min）. Isolating the accessory hemiazygos vein and ligating the distal end. 1000 ml lactated ringer solution were pumped into the vein and the rate is 860 ml/h and pumping time 70 minutes. Proxi- mal blood pressure, distal blood pressure, heart rate and the nasopharyngeal temperature were recorded every 10 minutes during the operation. After the operation, pigs were kept free access to food and water. Pigs of the simvastatin experimental group were fed with simvastatin tablets 80 mg/day, orally for 30 days. Recording the motor function score at 6, 24, 48 h after reperfusion （ see Taylor motor function scoring system）. All 8 pigs of each group were killed at 30 days after reperfusion and take the L2 - L5 and sacral spinal cord as quickly as possible to observe the express changes of IL-1, BDNF and GDNF applying immuno- chemistry, electron microscope and Elisa method. Results In the simvastatin experimental group, the 24, 48 h motor function scores were significantly higher than that in the control group （ P 〈 O. 05 ）. Compared with the control group, higher express changes of BDNF and GDNF and lower express of IL-1 can be found in the experimental group. Conclusion Simvastatin can significantly improve the neurological function recovery of spinal cord ischemia reperfusion injury. And it is related to higher express of BDNF GDNF and lower express of IL-1.

关 键 词：脊髓缺血 再灌注损伤 辛伐他汀 

分 类 号：R654.2[医药卫生—外科学]