刘颖,王迪芬,汪俊涛
LIU Ying~1,WANG Di-fen~1,WANG Jun-tao~2(1.Department of Intensive Care Unit

• 1:贵阳医学院附院重症监护室
• 2:贵阳医学院附院重症监护室
• 3:贵阳市妇幼保健院妇产科 贵州贵阳550004
• 4:贵州贵阳550004

摘要(Abstract)：

目的:探讨不同时间窗异丙酚预处理对沙土鼠脑缺血-再灌注损伤的保护作用。方法:蒙古沙土鼠66只,随机分为对照组(A),24 h预处理假手术组(B),缺血损伤组(C),异丙酚预处理12 h组(D)、24 h组(E)、48 h组(F)。B、C、D、E和F组中再分为术后即刻处死组和术后7 d处死组,共11组。24 h预处理假手术组术前24 h、异丙酚预处理组于脑缺血前12、24、48 h各组分别予异丙酚100 mg/kg腹腔注射。观察超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-px)、丙二醛(MAD)、内皮素(ET)和降钙素基因相关肽(CGRP);透射电镜观察脑组织超微结构的变化、并观察7 d后处死组沙土鼠的行为学变化。结果:异丙酚预处理各组的MDA的含量低于缺血损伤组(P<0.05);SOD、GSH-px的活性高于缺血损伤组(P<0.05),而CGRP的含量24 h、48 h预处理组明显高于缺血组(P<0.05);脑组织超微结构显示异丙酚预处理组出现轻微病变,缺血组病变严重;7 d后处死组与术后即刻处死组比较,神经元超微结构病变无明显加重。结论:缺血前12~48 h异丙酚预处理可不同程度上对沙土鼠的脑缺血-再灌注损伤有保护作用。
Objective: To study the protective effect of propofol pretreatment against cerebral ischemia-reperfusion injury in gerbils;to explore the duration and degree of the protection;and to study the optimal administration time window of propofol pretreatment for the protective effects,so as to provide theoretical basis for optional clinical therapy.Methods: 66 mongolian gerbils of both sexes,three months aged,and weighing 45~75g were randomly divided into: control group(A),pretreatment and sham operation group(B),ischemia-reperfusion group(C),and propofol groups(D-F).Propofol 100mg/kg was given intraperitoneally(ip) 12h(group D),24h(group E),and 48h(group F) before ischemia.And then,each group except group A was divided into two sub-groups: the immediately executing groups(X1) and the delayed executing groups(X2,executed in 7 days).There were 6 gerbils in each group.The gerbils in groups C-F were anesthetized with pentobarbital 36mg/kg ip,and their bilateral common carotid arteries were exposed and clamped for 20min.and then,unclamped for 50min for reperfusion.The animal bilateral common carotid arteries in groups A and B were exposed but not clamped.The animals of groups X1 were then decapitated and their forebrain cerebral cortex were removed for determination of ET,CGRP and MDA contents,and the activities of SOD and GSH-px.In addition,examination of the cellular ultrastructure was done with electronic microscopy.Results: In propofol groups,SOD and GSH-px activities were significantly higher than those in ischemia group(P<0.05);In propofol group E and group F,CGRP contents were significantly higher than those in group C(P<0.05).In propofol groups,MDA levels were significantly lower than those in group C(P<0.05);The destruction of neuron ultrastructure was more slight in propofol groups than in ischemia groups.The differences between the results of groups X1 and X2 were not significant.Conclusions: Propofol pretreatment at 12-48 hours before cerebral ischemia-reperfusion has protective effects of different degrees against cerebral ischemia-reperfusion injury,and the earlier the use of propofol,the better the protective results are.

关键词(KeyWords)： 缺血预处理;脑缺血发作,短暂性;异丙酚;再灌注损伤
ischemic preconditioning;ischemic attack,transient;reperfusion injury

Abstract:

Keywords:

基金项目(Foundation): 贵州省科学技术基金项目(20003011)

作者(Author): 刘颖,王迪芬,汪俊涛
LIU Ying~1,WANG Di-fen~1,WANG Jun-tao~2(1.Department of Intensive Care Unit

DOI: 10.19367/j.cnki.1000-2707.2006.03.006

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