大脑皮质线粒体功能障碍在猪复苏后急性脑损伤中的作用  

Effect of mitochondrial dysfunction of the cerebral cortex on acute postresuscitation brain injury after prolonged cardiac arrest in the swine

作　　者：张军利[1] 漆楠楠 史继学[1] 程岳雷[1] 周亚东[1] 汤庆宾[1] 顾伟[2] 

机构地区：[1]泰山医学院附属医院急诊科,山东泰安271000 [2]首都医科大学附属北京朝阳医院急诊科

出　　处：《临床急诊杂志》2016年第3期202-206,共5页Journal of Clinical Emergency

基　　金：国家自然科学基金(No:81372025);北京市属医院科研培育计划(No:PX2016022);吴阶平医学基金会临床科研专项资助基金(No:320.6750.15039);首都医科大学基础-临床科研合作基金(No:15JL42)

摘　　要：目的:探讨大脑皮质线粒体功能障碍是否参与猪心肺复苏后急性脑损伤的机制。方法:建立室颤8min的猪心肺复苏模型。26头猪随机分为假手术组(n=6)、复苏后12h组(n=10)和复苏后24h组(n=10),自主循环恢复(ROSC)后,采用差速离心法提取大脑皮质神经细胞的线粒体,采用流式细胞仪检测大脑皮层线粒体膜电位(MMP),通过线粒体光散射检测线粒体通透性转运孔(MPTP)的开放。结果:复苏后12、24h组猪脑功能发生了严重的损伤,表现为电镜下脑细胞超微结构的严重破坏和神经功能缺损评分的显著增加;复苏后12、24h组猪大脑额叶皮质神经细胞MMP显著低于假手术组(P<0.01);与假手术组比较,复苏后12、24h组猪大脑额叶皮质神经细胞MPTP的开放显著增加,线粒体光密度也出现显著的降低,提示线粒体出现明显肿胀和损伤。结论:大脑皮质线粒体功能障碍可能参与了复苏后急性脑组织损伤的过程。Objective：To investigate the role of mitochondrial dysfunction in acute postresuscitation brain injury.Method：After pigs were subjected to 8mins of electrically induced cardiac arrest,26 Wuzhishan miniature pigs were randomly divided into sham-operated group（n=6）,post-return of spontaneous circulation（ROSC）12h（n=10）and 24h（n=10）group.Surviving pigs were sacrificed at 12 and 24hafter ROSC and brains were removed for analysis by electron microscopy,mitochondrial transmembrane potential（MTP）by flow cytometry,opening of the mitochondrial permeability transition pore（MPTP）by mitochondrial light scattering.Result：Brain functions of pigs were impaired significantly after ROSC,presented as increase of NDS scores,severe damage of cytoplasmic ultrastructure of brain tissue under an electron microscope.Compared with the sham-operated group,cortical neurons in the cerebral frontal lobe showed significantly decreased level of MMP in ROSC 12 hand 24hgroup（P〈0.01）.In addition,cortical neurons showed significantly lower mitochondria light density in ROSC 12 hand 24hgroup,indicating obvious swelling of mitochondria and obvious opening of MPTP.Conclusion：The mitochondrial dysfunction of the cerebral cortex may be involved in the process of acute postresuscitation brain injury in a porcine model of cardiac arrest.

关 键 词：心肺复苏 急性脑损伤 线粒体功能障碍 心搏骤停 

分 类 号：R459.7[医药卫生—急诊医学]