摘要
目的探讨上胸段硬膜外阻滞(HTEA)对大鼠脑缺血再灌注损伤的作用及可能机制。方法健康雄性Wistar大鼠24只,随机分成3组(n=8)：假手术组(SH组)、缺血再灌注组(I/R组)和HTEA组。采用四血管阻断法制作全脑缺血再灌注损伤模型,缺血20 min。HTEA组在缺血前2 h行HTEA,于T_(4,5)每8 h注入0．125%布比卡因100μl·kg^(-1),直至再灌注72 h处死大鼠,SH组、I/R组给予等量生理盐水。取脑组织,HE染色、免疫组织化学技术和原位末端标记法检测双侧海马CAI区存活细胞数、凋亡细胞及聚腺苷二磷酸核糖聚合酶(PARP)表达。结果脑缺血再灌注可导致海马CAI区存活细胞数下降,凋亡细胞数、PARP表达升高,HTEA可减弱缺血再灌注导致的上述改变。结论HTEA可减轻大鼠脑缺血再灌注损伤。
Objective To investigate the effects of high thoracic epidural anesthesia （HTEA） on cerebral ischemia-reperfusion （I/R） injury and the possible mechanism. Methods Twenty-four healthy male Wistar rats weighing 260-320 g were randomly divided into 3 groups （ n = 8 each） ： group Ⅰ sham operation （S） ： groupⅡ I/R and group Ⅲ HTEA ＋ I/R. The animals were anesthetized with intraperitoneal 0.6 % pentobarbital sodium 36 mg. kg^-1 . Epidural catheter was placed at T4,5 interspace and advanced 1.5 cm into epidural space cephalad 2 h before cerebral ischemia. 0.125 % bupivacaine 100μl.kg^-1 was injected via epidural catheter every 8 h from 2 h before cerebral ischemia until 72 h reperfusion. Global cerebral ischemia was produced by 4-vessel technique and maintained for 20 rain in group Ⅱ and Ⅲ. Global cerebral ischemia was confirmed by isoelectric EEG, pupil dilation and loss of fighting reflex. In group Ⅰ bilateral common carotid arteries were exposed but not occluded. In group Ⅰ and Ⅱ normal saline was injected via epidural catheter instead of 0.125 % bupivacaine. The rats were decapitated at the end of 72 h reperfusion. Their brains were removed. The amount of living neurons in the hippocampus CA1 region was detected by HE-staining. The amount of apoptotic neurons in hippocampus CA1 was detected by TUNEL and the expression of PARP enzyme in hippocampus CA1 was determined by immuno- histochemistry. Results Global cerebral I/R significantly decreased the number of living neurons and increased the number of apoptotic neurons and expression of PARP enzyme in the hippocampus CA1 region as compared with sham operation group. HTEA significantly attenuated the changes induced by 1/R. Conclusion HTEA can mitigate cerebral I/R injury.
出处
《中华麻醉学杂志》
CAS
CSCD
北大核心
2006年第8期710-713,共4页
Chinese Journal of Anesthesiology
关键词
麻醉
硬膜外
脑缺血
再灌注损伤
Anesthesia, epidural
Cerebral ischemia
Reperfusion injury
