观察远隔肢体缺血对大鼠急性脑梗死再灌注损伤的保护效应及其机制的探讨  

Effects and mechanisms of remote limbs ischemic on acute cerebral ischemia reperfusion in rats

作　　者：石秋艳[1] 陈历[1] 刘爱东[2] 张春阳[1] 孙原[1] 孙尚帛 

机构地区：[1]河北联合大学附属医院神经内科,河北唐山063000 [2]河北联合大学附属医院病理科,河北唐山063000 [3]河北联合大学基础医学院,河北唐山063000

出　　处：《现代预防医学》2015年第11期2042-2044,2053,共4页Modern Preventive Medicine

摘　　要：目的探讨远隔肢体缺血对大鼠急性脑梗死再灌注损伤的保护效应及其机制的探讨。方法实验选取大鼠196只,采用抽签法随机分为7组,每组28只:假手术组;缺血再灌注24 h组;夹闭股动脉24 h组;缺血再灌注72 h组;夹闭股动脉72 h组;缺血再灌注5 d组;夹闭股动脉5 d组。建立大鼠大脑中动脉闭塞(MCAO)模型2 h后采用轮流夹闭双下肢股动脉主干,2 min缺血/2 min再灌注,各5个周期,连续5 d进行夹闭股动脉。比较脑梗死体积,应用免疫组化方法检测Eph A2、β-淀粉样蛋白(Aβ)的表达。结果 MACO后再灌注与夹闭股动脉脑梗死灶体积均逐渐增大,5 d比72 h脑梗死体积均略大,但差异无统计学意义;夹闭股动脉72 h、5 d脑梗死灶体积均比再灌注同时间组小(32.67±1.13比36.93±1.57;33.83±2.15比33.83±2.15);再灌注和夹闭股动脉各时间组大鼠脑梗死周围区域的Eph A2及Aβ的阳性细胞数均比假手术组显著升高,再灌注与夹闭股动脉24 h组Eph A2及Aβ表达均开始增多,72 h达高峰(38.40±1.82,25.50±1.29),5 d开始下降,夹闭股动脉72 h、5 d组比再灌注组同一时间Eph A2及Aβ的阳性细胞数均较低(Eph A2:25.50±1.29比38.40±1.82,21.67±4.92比32.93±2.53;Aβ:29.75±1.50比41.07±1.15,23.24±1.45比34.60±2.36)。结论远隔肢体缺血的确存在减轻大鼠急性脑梗死再灌注损伤的作用,脑梗死周围区Eph A2和Aβ表达水平的降低或为对抗再灌注损伤的机制。Objective To investigate the protective effect and its mechanism of limb ischemia remote on acute cerebral infarction and reperfusion injury in rats. Methods 196 male rats were randomly divided into seven groups： sham group （n=28）, ischemia/ reperfusion one day group （n=28）, clip femoral artery one day group （n=28）, ischemia/reperfusion 72h group （n=28）, clip femoral artery 72h group （n=28）, isehemia/reperfusion 5d group （n=28）, clip femoral artery 5d group （n=28）. We established the mouse brain middle cerehral artery occlusion （MCAO） model. After 2 hours of MCAO establishment, the animals underwent clipping bilateral femoral artery trunk, consisting of 3 cycles with each occlusion or release lasting for 2 min of bilateral femoral artery occlusion/release. Infarct volume were compared, and the immunohistochemistry method was used to detect EphA2, Beta amyloid protein expression. Results After MCAO, both ischemia reperfusion group and clip femoral artery group cerebral infarction volume increased gradually. Cerebral infarction volume of 5d group was slightly larger than that of 72h group. But there was no statistically significant difference. Cerebral infarction volumes of clip femoral artery 72h group and 5d group were smaller than that of reperfusion group （32.67 ＋ 1.13 VS 36.93 ＋ 1.57; 33.83 ＋ 2.15 VS 33.83 ~ 2.15）. The level of EphA2 and Beta amyloid protein in neurons and endothelial cells in the peri-infarct region of Ischemia reperfusion and limb isehemia postconditioningclip femoral artery significantly increased than the Sham group at each time. Expressions of EphA2 and A 13 increased after 24h of MCAO. It took 72h to go to the peak （38.40± 1.82, 25.50 ± 1.29）, and 5d to decline. After 72h and 5d of MCAO, the levels of EphA2 and Beta amyloid protein in neurons and endothelial cells in the peri-infarct region at the Limb ischemia postconditioning group were lower than those of reperfusion group （EphA2：25.50 ±1.29 VS 38.40 ± 1.82; 21.67± 4.92 VS 32.93

关 键 词：缺血再灌注损伤 夹闭双侧股动脉主干 大鼠 中动脉闭塞 EPH A2 AΒ 

分 类 号：R115[医药卫生—公共卫生与预防医学]