雌激素对急性一氧化碳中毒迟发性脑病的研究  

Early estrogen intervention has therapeutic effect on delayed neuropsychologic sequelae in acute carbon monoxide poisoning

作　　者：刘勇 王仲霞[3] 李虎年[1] 黄光庆[1] 赵旭[1] 尤志珺[4] 付守芝 

机构地区：[1]湖北医药学院附属人民医院重症医学科,湖北十堰442000 [2]香港大学深圳医院重症医学科 [3]湖北医药学院附属人民医院医务处 [4]湖北医药学院附属人民医院老年病科 [5]武汉市第三医院急诊科

出　　处：《临床急诊杂志》2015年第4期279-283,286,共6页Journal of Clinical Emergency

基　　金：2009-2010年度湖北省科技厅自然科学基金(No:2006ABA339);湖北省卫生厅科研项目(No:2009JX2B92)

摘　　要：目的：研究雌激素干预对急性一氧化碳（CO）中毒迟发性脑病（DNS）的防治作用,探索有效的临床治疗手段。方法：选择成年Wistar雌性大鼠。腹腔注入CO（150ml/kg）建立CO中毒DNS模型。存活大鼠随机分为对照组和雌激素组。中毒2~6周后水迷宫试验评估动物的智力状态,苏木精-伊红染色观察脑组织病理改变,TUNEL法检测脑组织细胞凋亡。结果：实验动物腹腔注入CO后出现智力下降,脑组织细胞凋亡明显,符合DNS表现。雌激素干预可显著改善模型动物智力,减轻脑组织病理损害,降低细胞凋亡率。雌激素主要通过抑制凋亡相关信号通道Bcl-2来实现对神经的保护作用。结论：早期雌激素干预可有效降低CO中毒DNS发病率,显著减轻CO中毒DNS损害程度。Objective：To investigate the effect of estrogen intervention on delayed neuropsychologic sequelae（DNS）in acute carbon monoxide（CO）poisoning.Method：Adult Wistar rats were selected and were infused CO（150ml/kg）by intraperitoneal injection to build DNS model.The rats were radomly grouped.Group of Estrogen（5μg/kg）were injected Estrogen（5μg/kg）with 30 min after poisoning.Morris maze test was adopted to evaluate the intelligence of rats.The apoptosis rates in brain was detected by TUNEL staining.The expression levels of Bcl,ERK1/2and P38 protein were determined with western blot analysis.Result：After CO infusing,poisoning rats showed intelligence decline,leukoence demyeliation and apoptosis increasing,which coincided to DNS.After early estrogen intervention,the intelligence,leukoence demyeliation,brain lesion and apoptosis rates were ameliorated significantly.Western blot showed the protein expression of Bcl significantly increased,while level of ERK1/2and P38 had no signicantly difference.Conclusion：Early Estrogen intervention can effectively decrease the rates and alleviate the damage of DNS occur after acute CO poisoning.Its effects may be due to stimulating early expression of bcl-2and ERK and inhibiteded P38 protein.

关 键 词：一氧化碳中毒迟发性脑病 雌激素 细胞凋亡 

分 类 号：R-33[医药卫生]