甘露醇不同时间给药联合醒脑静对实验性脑出血大鼠灶周水肿的影响  

The effect of different therapeutic intervention time of mannitol combined with Xingnaojing on cerebral dema in rats with experimental intracerebral hemorrhage

作　　者：张运[1] 王莉莉[1] 唐涛[1] 贺茂林[1] ZHANG Yun;WANG Lili;TANG Tao(Department of Neurology,Beijing Shjitan Hospital,Capital Medical University,Beijing 100038,China)

机构地区：[1]首都医科大学附属北京世纪坛医院神经内科,北京100038

出　　处：《中风与神经疾病杂志》2018年第10期868-872,共5页Journal of Apoplexy and Nervous Diseases

基　　金：北京市科委2014年度科技计划重大项目"出血性脑血管病诊治及预后干预策略研究"(No.D141100000114001)

摘　　要：目的观察甘露醇不同时间给药联合醒脑静对实验性脑出血大鼠灶周水肿、炎性因子、行为学的影响。方法健康雄性SD大鼠126只,采用自体动脉血注入法制作大鼠脑出血模型,分为假手术组、模型对照组、醒脑静组、甘露醇6 h组、甘露醇6 h+醒脑静组、甘露醇24 h组、甘露醇24 h+醒脑静组、甘露醇48 h组、甘露醇48 h+醒脑静组,共9个组。各组分别于术前、术后24 h、48 h、1 w完成行为学检测,取损伤区脑组织观察灶周脑组织含水量,检测并比较白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)的表达。结果造模后24 h,各脑出血模型组神经功能缺损评分均显著高于假手术对照组(P <0. 01)。仅甘露醇24 h+醒脑静组在72 h及1 w时神经功能评分显著低于同时间点模型对照组(P <0. 01),也低于同时间点甘露醇24 h组(P <0. 05)。甘露醇24 h+醒脑静组脑含水量在72 h、1 w时含水量为模型鼠最低,均低于同时间点模型对照组(P <0. 01);在72 h该组脑含水量显著低于甘露醇48 h+醒脑静组与甘露醇6 h+醒脑静组(P <0. 05)。此外,甘露醇24 h+醒脑静组在72 h、1 w时检测炎性因子IL-1β、TNF-α的表达强度均值为各组最低,显著低于同时间点模型对照组与甘露醇24 h组(P <0. 01)。结论 24 h给与甘露醇联合醒脑静治疗,能够下调IL-1β、TNF-α的表达,减轻脑出血大鼠灶周水肿,改善神经功能,其疗效优于单独给于甘露醇或醒脑静治疗。Objective To observe the effect of different therapeutic intervention time of mannitol combined with Xingnaojing on cerebral dema,inflammatory factors and behavior in rats with experimental intracerebral hemorrhage.Methods 126 healthy male SD rats were injected with autologous arterial blood injection to make a rat model of intracerebral hemorrhage,which were divided into 9 groups.The behavior tests were performed before operation,24 h,48 h and 1 weeks after operation.The water content of the brain tissue was observed.The expression of the inflammatory factors were compared.Results After 24 h of operation,each intracerebral hemorrhage model group’score of behavior tests was significantly higher than that of the sham control group(P<0.01).The behavior test scores of mannitol 24 h+Xingnaojing group at 72 h and 1 weeks were significantly lower than those in the same time point model group(P<0.01,respectively),and lower than the same time point mannitol 24 h group(P<0.05).The brain water content of mannitol 24 h+Xingnaojing group was lower than that of the same time point model control group(P<0.01)at 72 h and 1 weeks,while the brain water content in the 72 h group was lower than that of mannitol 48 h+Xingnaojing group and mannitol 6 h+Xingnaojing group(P<0.05).In addition,the mean value of expression intensity of IL-1βand TNF-αin the mannitol 24 h+Xingnaojing group at 72 h and 1 weeks was the lowest(P<0.01).Conclusion 24 h combined with mannitol and Xingnaojing treatment group can reduce the expression of IL-1βand TNF-α,reduce the edema and improve the nerve function in the rats.Its effect is better than that of mannitol or Xingnaojing alone.

关 键 词：脑出血 脑水肿 甘露醇 醒脑静 

分 类 号：R743.34[医药卫生—神经病学与精神病学]