术后谵妄大鼠血脑脊液屏障的变化  

Changes in blood-cerebrospinal fluid barrier in postoperative delirium rats

作　　者：郭美美 周莹 陈磊[1] 李可 王焱林[1] 张宗泽[1] 彭勉[1] Guo Meimei;Zhou Ying;Chen Lei;Li Ke;Wang Yanlin;Zhang Zongze;Peng Mian(Department of Anesthesiology,Zhongnan Hospital of Wuhan University,Wuhan 430071,China)

机构地区：[1]武汉大学中南医院麻醉科,430071

出　　处：《中华麻醉学杂志》2021年第1期43-47,共5页Chinese Journal of Anesthesiology

基　　金：国家自然科学基金(81371195,81870851,82071208);湖北省医学青年拔尖人才计划(2020)。

摘　　要：目的评价术后谵妄大鼠血脑脊液屏障的变化。方法SPF级健康雌性SD大鼠147只,3月龄,体重240~300 g,采用随机数字表法分成3组(n=49):对照组(C组)、单纯麻醉组(A组)和术后谵妄组(P组)。C组大鼠不接受麻醉和手术处理,A组大鼠接受1.4%异氟烷麻醉2 h处理,P组大鼠在1.4%异氟烷麻醉下行剖腹探查术。于术前24 h、术后6、9和24 h时测试大鼠行为学(埋藏食物实验、旷场实验及Y迷宫实验);术后6、9和24 h于大鼠尾静脉注射荧光素钠(NaFI)后取大鼠双侧侧脑室脉络丛(CP)及脑脊液(CSF),采用Western blot法检测CP ZO-1、occludin、claudin1、E-cadherin和VE-cadherin表达;术后6 h时大鼠尾静脉注射10、40和70 kDa FITC-dextran后取CSF,通过荧光分光光度法检测CSF NaFI,10、40和70 kDa FITC-dextran的浓度;取CP在透射电镜下观察大鼠双侧CP上皮细胞(CPECs)形态。结果与C组和A组比较,P组大鼠术后食用麦片潜伏期延长,中央格停留时间缩短,进入新异臂次数百分比及新异臂停留时间百分比降低,僵直时间缩短,大鼠CP ZO-1、occludin和claudin1表达下调,CSF NaFI浓度、10及40 kDa FITC-dextran浓度增加(P<0.05或0.01),CPECs排列紊乱疏松,微绒毛缺失,细胞间紧密连接局部模糊不清,间隙增宽。结论术后谵妄的发生与血脑脊液屏障的变化有关。Objective To evaluate the changes in the blood-cerebrospinal fluid barrier in postoperative delirium rats.Methods One hundred and forty-seven healthy female Sprague-Dawley rats,aged 3 months,weighing 240-300 g,were divided into 3 groups(n=49 each)using a random number table method:control group(group C),anesthesia group(group A)and postoperative delirium group(group P).Group C received no treatment.Group A received 2-h anesthesia with 1.4%isoflurane.Group S underwent an exploratory laparotomy under 1.4%isoflurane anesthesia.The behaviors of rats in each group were tested at 24 h before surgery and 6,9 and 24 h after surgery using buried food test,open field test and Y maze test.Sodium fluorescence was injected through the tail vein at 6,9 and 24 h after surgery.Then the rats were sacrificed,the choroid plexus(CP)was obtained,and cerebrospinal fluid(CSF)of bilateral cerebral ventricles was collected,and the expression of ZO-1,occludin,claudin1,E-cadherin and VE-cadherin in CP was detected using Western blot.FITC-dextran 10,40 and 70 kDa was injected through the tail vein at 6 h after surgery,and then CSF was collected for determination of the concentrations of NaFI,10,40 and 70 kDa fluorescein isothiocyanate labeled dextran(FITC-dextran)in CSF by fluorescence spectrophotometry.CP was obtained to observe the morphology of choroid plexus epithelial cells(CPECs)of bilateral cerebral ventricles with a transmission electron microscope.Results Compared with group C and group A,the latency to eat food in buried food test was significantly prolonged,the time of staying at the central region was shortened,the percentage of the number of entries into novel arm and percentage of time of staying at novel arm in Y maze test were decreased,the freezing time in open field test was shortened,the expression of ZO-1,occludin and claudin1 in CP was down-regulated,the concentrations of NaFI and 10 kDa and 40 kDa FITC-dextranin CSF were increased(P<0.05 or 0.01),the CPECs arranged at random and loose,the microvilli of CPECs were absen

关 键 词：脑脊液 脉络丛组织 谵妄 手术后并发症 

分 类 号：R614[医药卫生—麻醉学]