| 摘要: |
| 目的 探讨小脑延髓池注射纳洛酮对心肺复苏大鼠脑组织病理损伤及血清S100β蛋白、神经元特异性烯醇化酶(NSE)的影响. 方法 取成年雄性SD大鼠30只,随机分为假手术组、常规复苏组(静脉注射肾上腺素0.2 mg/kg)和纳洛酮复苏组(小脑延髓池注射纳洛酮2 mg/kg),每组10只.采用窒息法建立大鼠心肺复苏模型,复苏同时给药治疗.分别于恢复自主循环(ROSC)后0.5、3、6和24 h眼眶静脉丛取血,ELISA 法测定血清 S100β蛋白、神经元特异性烯醇化酶(NSE)水平.最后一次取血后取脑组织,采用H-E染色观察大鼠脑组织病理改变. 结果 常规复苏组及纳洛酮复苏组各时间点大鼠血清S100β蛋白浓度均高于假手术组(P <0.01);与常规复苏组比较,ROSC后3、6、24 h纳洛酮复苏组大鼠血清S100β蛋白浓度降低(P <0.05或P <0.01).常规复苏组各时间点及纳洛酮复苏组ROSC后6、24 h血清NSE蛋白浓度均高于假手术组(P <0.05或P <0.01);与常规复苏组比较,ROSC后6、24 h纳洛酮复苏组大鼠血清NSE蛋白浓度降低(P <0.05或P <0.01).形态学观察结果表明,常规复苏组海马区神经胶质细胞排列散乱,数量减少,胞质浓缩嗜伊红、胞核固缩、核仁不清,毛细血管明显肿胀变形,微血管体积扩大,而纳洛酮复苏组大部分神经细胞胞质丰富,核仁清楚,仅少数神经细胞和毛细血管出现程度不等的水肿样改变及胞核固缩现象. 结论 小脑延髓池注射纳洛酮对心肺复苏大鼠脑组织具有明显的保护作用. |
| 关键词: 小脑延髓池 心肺复苏术 纳洛酮 再灌注损伤 S100β蛋白 神经元特异性烯醇化酶 |
| DOI：10.3724/SP.J.1008.2015.00794 |
| 投稿时间：2015-06-03修订日期：2015-07-13 |
| 基金项目:广东省科技计划项目(2013B022000028). |
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| Protective effect of naloxone injected into cisterna magna on brain tissues of rats following cardiopulmonary resuscitation |
| ZHU Ming-hui*,LU Wan-hui,LI Jing-lin,CHENG Qiu-sheng,HU Guang-fen,LIU Si-hong,DENG Sui-de,YU Ning-fang |
(Department of Emergency, Guangzhou First People's Hospital, Guangzhou 510180, Guangdong, China
*Corresponding author) |
| Abstract: |
| Objective To investigate the effects of naloxone injected into cisterna magna on S100β protein and neuron-specific enolase (NSE) levels in serum and the histopathology of brain tissue of rats following cardiopulmonary resuscitation(CPR). Methods Thirty adult male SD rats were randomly divided into 3 groups: Sham group, Conventional CPR group (intravenous injection of epinephrine, 0.2 mg/kg) and Naloxone CPR group(cisterna magna injection of naloxone, 2 mg/kg). Asphyxiation was used to set up rat cardiac arrest model, and corresponding drugs were given when the resuscitation was carried out. The blood samples were taken from orbital venous plexus at 0.5 h, 3 h, 6 h and 24 h after restoration of spontaneous circulation (ROSC). Enzyme-linked immunosorbent assay (ELISA) was used to detect serum levels of S100β protein and NSE. Brain tissue was taken after the last blood sampling and the pathology of brain was observed by hematoxylin-eosin (H-E) staining. Results Serum S100β protein levels of the Conventional CPR group and Naloxone CPR group were significantly higher than those of the Sham group at all time points (P <0.01); compared with the Conventional CPR group, S100β protein levels in Naloxone CPR group were significantly decreased at 3 h, 6 h, and 24 h after ROSC (P <0.05 or P <0.01). Serum NSE protein level of the Conventional CPR group at all time points and Naloxone CPR group at 6 h and 24 h after ROSC were significantly higher than those of the Sham group (P <0.05 or P <0.01). Serum NSE protein levels were significantly decreased at 6 h and 24 h after ROSC in Naloxone CPR group compared with the Conventional CPR group (P <0.05 or P <0.01). Moreover, hippocampus glial cells of Conventional CPR group were scattered and decreased, with condensed eosinophilic cytoplasm, narrowed nuclues, unclear nucleolus, and swollen and deformed capillaries. However, most nerve cells of Naloxone CPR group had rich cytoplasm and the nucleolus was clear; only a few nerve cells and capillaries showed edema-like changes of different degrees. Conclusion Naloxone injected into cisterna magna has a prominent protective effect on the brain of rats following cardiopulmonary resuscitation. |
| Key words: cisterna magna cardiopulmonary resuscitation naloxone reperfusion injury S100β protein neuron-specific enolase |
