低温环境下七氟醚对失血性休克猪脑损伤的影响  

Effect of sevoflurane on brain injury in a pig model of hemorrhagic shock in hypothermia environ-ment

作　　者：李佳男[1] 邹彬[2] 曹惠鹃[2] 张铁铮[2] 

机构地区：[1]辽宁医学院沈阳军区总医院研究生培养基地,110016 [2]沈阳军区总医院麻醉科,110016

出　　处：《中华麻醉学杂志》2015年第12期1491-1494,共4页Chinese Journal of Anesthesiology

基　　金：军队后勤科研重点项目（BWS12J008）

摘　　要：目的评价低温环境下七氟醚对失血性休克猪脑损伤的影响。方法选择巴马小型猪24头，体重21～25kg，3～5月龄，雌雄不拘，采用随机数字表法分为3组（n=8）：假手术组（Sham组）、失血性休克组（HS组）和七氟醚组（Sev组）。行双侧股动脉和颈内静脉穿刺置管，待动物清醒后，置于-15℃低温环境中。HS组和Sev组采用容量控制法建立失血性休克模型，于15min内将40％血容量（按30ml／kg计算）经右股动脉匀速放出；Sev组于失血性休克模型制备成功后吸人2％七氟醚30min。分别于失血性休克前和失血性休克后30、60、90、120、180和240min（T0-6）时，采集股动脉血样，采用ELISA法测定血浆TNF-α、IL-6、NF-κB、S100β蛋白和神经元特异性烯醇化酶（NSE）的浓度。T6采血后处死动物，取脑组织，光镜下观察病理学结果，采用Westernblot法检测Toll样受体4（TLR4）的表达水平。结果与Sham组比较，HS组和Sev组T2-6时血浆NSE、S100β蛋白、TNF-α、IL-6和NF-κB的浓度升高，T6时脑组织TLR4表达上调（P〈O．05）；与HS组比较，Sev组T4-6时血浆NSE和S100β蛋白的浓度降低，T2-6时血浆TNF-α、IL-6和NF-κB的浓度降低，T6时脑组织TLR4表达下调（P〈0．05），病理学损伤减轻。结论低温环境下七氟醚可减轻失血性休克猪脑损伤，其机制可能与抑制TLR4／NF-κB信号通路，减轻炎性反应有关。Objective To evaluate the effect of sevoflurane on brain injury in a pig model of hem- orrhagie shock in hypothermia environment. Methods Twenty-four Bama miniature pigs, weighing 21-25 kg, aged 3-5 months, were equally randomized into 3 groups using a random number table： sham opera- tion group （ group Sham） ; hemorrhagic shock （ group HS） ; sevoflurane group （ group Sev）. The animals were anesthetized, tracheostomized and mechanically ventilated. Bilateral femoral arteries were cannulated for continuous mean arterial pressure, and heart rate monitoring, blood-letting and blood sampling. A cath- eter was inserted into the right internal jugular vein for body temperature monitoring. After the animals were awake, they were placed in an environment at - 15℃. Hemorrhagic shock was induced by withdrawing 40% of blood volume from the right femoral artery within 15 min （30 ml/kg） in HS and Sev groups. The animals inhaled 2% sevoflurane for 30 min after establishment of the model in group Sev. Before hemorrhagic shock, and at 30, 60, 90, 120, 180 and 240 h after hemorrhagic shock （T0-6）, blood samples were collected from the femoral artery for determination of plasma tumor necrosis factor-alpha （TNF-α） , interleukin-6 （IL-6） , nuclear factor kappa B （NF-κB） , S100β protein and neuron-specific enolase （NSE） concentra- tions. After blood sampling at T6, the animals were sacrificed, and brains were removed for microscopic examination of pathological changes, and for determination of Toll-like receptor 4 （TLR4） expression by Western blot. Results Compared with group Sham, the plasma NSE, S10015 protein, TNF-α, IL-6 and NF-κB concentrations were significantly increased at T2-6, and TLR4 expression was up-regulated at T6 in HS and Sev groups （P〈0.05）. Compared with group HS, the plasma NSE, and S100β protein concentra- tions were significantly decreased at T4-6, the plasma TNF-α, IL-6 and NF-κB concentrations were de- creased at T2-6, and TLR4 expression was down-regul

关 键 词：低温 麻醉药 吸入 休克 出血性 脑损伤 

分 类 号：R614[医药卫生—麻醉学]