摘要
目的观察轻度急性等容血液稀释(ANH)对兔局灶性脑缺血再灌注后早期颈静脉血乳酸(VBL)、S100-β蛋白及肿瘤坏死因子-α(TNF-α)的影响。方法 18只新西兰大白兔随机分为假手术组(S组,n=6)、缺血再灌注组(IR组,n=6)及血液稀释-缺血再灌注组(HIR组,n=6)。参照Longa实验方法建立右大脑中动脉栓塞模型。S组只行血管分离,IR组经右大脑中动脉栓塞行局灶性脑缺血2 h后再灌注,HIR组缺血前20 min使用6%羟乙基淀粉(万汶130/0.4)行ANH,稀释目标Hct=30%。于缺血前(T0)、缺血1 h(T1)及再灌注后1 h(T2)、2 h(T3)、4 h(T4)分别抽取颈内静脉血检测VBL,另抽取颈内静脉血4 mL,经10%EDTA抗凝,3 000 r/min离心,取血清-70℃保存,采用酶联免疫吸附法(ELISA)测定TNF-α和S100-β蛋白含量。结果 IR组和HIR组T1、T2、T3、T4的VBL、S100-β蛋白水平较T0均升高(P<0.05),但HIR组的升高幅度低于IR组(P<0.05);3组T1、T2、T3、T4时TNF-α浓度均高于T0时(P<0.05,P<0.01),IR组和HIR高于S组(P<0.05,P<0.01),而IR组又高于HIR组(P<0.05)。结论以Hct=30%为目标实施轻度ANH,有利于兔缺血再灌注后早期脑组织的氧供和利用,减少炎症反应,降低继发性脑组织损害。
Objective To investigate the effect of mild acute isovolemic hemodilution on VBL, S100 - β and TNF - α after reperfusion of focal brain ischemia in rabbits. Methods Eighteen New Zealand rabbits were randomly divided into 3 groups （n = 6） ： sham operated group （Group S）, ischemia- reperfusion group （Group IR）, and hemodilutionischemia -reperfusion group （Group HIR）. The right middle cerebral artery embolism model was constructed according to Longa＇s method. Rabbits in Group S only received angiodiastasis as sham operation. Ischemia was created by embolism for 2 hours followed by reperfusion in rabbits of Group IR, while pro - dilution with 6% hetastarch （130/0. 4） until Hct reached 30% 20 min before embolism were applied in rabbits of Group HIR. VBL, S100 - β,TNF -α were measured at baseline （T0 ）, 1 h after ischemia （T1 ）, and 1 h （T2 ）, 2 h （ T3 ） , and 4 h after reperfusion （ T4 ）. Results The levels of VBL and S100 - 15 at T1 ,T2 ,T3 ,T4 were significantly increased compared with those at TO in Group IR and HIR （P 〈 0.05 ）, with significantly more prominence in group IR （ P 〈 0. 05 ）. The concentrations of TNF - α at T1, T2, T3, T4 were significantly higher than those at TO in all 3 groups （ P 〈 0.05, P 〈 0. 01 ）, with significantly most prominence in Group IR, following with that in Group HIR （P 〈 0. 05）. Conclusion Mild acute isovolemic hemodilution benefits the oxygen supply for brain tissue, reduces inflammatory reaction, and alleviates secondary brain injury after brain ischemia - reperfusion in rabbits.
出处
《广东医学》
CAS
CSCD
北大核心
2011年第22期2897-2899,共3页
Guangdong Medical Journal
基金
广东省科技计划项目(编号:2010B060900089)
