本文選題：星狀神經節(jié)阻滯 + 體外循環(huán)�。� 參考：《廣西醫(yī)科大學》2014年碩士論文

【摘要】：目的：建立大鼠右側星狀神經節(jié)阻滯(SGB)模型和心臟不停跳體外循環(huán)（CPB）模型，檢測CPB后大鼠海馬caspase-3mRNA及蛋白的表達，探討CPB是否對大鼠海馬造成損傷，觀察右側SGB對CPB后大鼠海馬caspase-3mRNA及蛋白表達的影響，探討右側SGB在CPB的腦損傷中是否有保護作用及其相關的作用機制。 方法：選用40只SPF級SD大鼠隨機分為S組，R組,C組和RC組4組，每組10只。S組為假手術組，僅插管不轉體外循環(huán)。R組為單純右側星狀神經節(jié)阻滯后插管不轉體外循環(huán)組。C組為單純體外循環(huán)組。RC組為右側星狀神經節(jié)阻滯加體外循環(huán)組。R組與RC組用0.25%布匹卡因0.2ml后入路行右側星狀神經節(jié)阻滯。C組和RC組轉流1h結束體外循環(huán)停機后監(jiān)測3h。R組、S組插管成功后監(jiān)測觀察4h終止實驗。實驗過程監(jiān)測大鼠的生命體征、血氣等。實驗結束,快速分離大鼠海馬組織，，部分-80℃保存?zhèn)溆糜谀孓D錄-聚合酶鏈反應（RT-PCR）檢測caspase-3mRNA的表達。部分海馬組織用中性甲醛固定后石蠟包埋切片,行免疫組化法檢測海馬神經元caspase-3蛋白的表達。部分用電鏡觀察海馬神經元超微結構的改變。 結果：可以成功建立大鼠SGB和CPB模型。 C組和RC組大鼠海馬組織的casepase-3mRNA與蛋白表達較S組升高，差異有統(tǒng)計學意義（P＜0.05），RC組海馬組織的casepase-3mRNA表達與蛋白表達較C組的低，差異有統(tǒng)計學意義（P＜0.05）。S組和R組大鼠海馬組織casepase-3mRNA與蛋白表達間的比較，差異無統(tǒng)計學意義（P＞0.05）。S組和R組的海馬神經元結構基本正常，核仁明顯，核膜清晰，染色質均勻，細胞核周圍細胞器較多。C組和RC組的神經元超微結構明顯損傷,核仁溶解消失，核皺縮，細胞核周圍細胞器減少，出現明顯的神經元凋亡現象。RC組神經細胞超微結構的損傷程度較C組的輕。 結論：大鼠SGB和CPB模型是用以研究SGB作用機制和心臟不停跳CPB損傷機制的理想動物模型。大鼠CPB后出現腦損傷，海馬組織caspase-3mRNA和蛋白的表達明顯增高，大鼠海馬神經元超微結構明顯破壞，出現凋亡現象。SGB可以抑制CPB后大鼠海馬神經元caspase-3mRNA和蛋白的表達，減緩細胞凋亡進程，對CPB的腦損傷產生保護作用。
[Abstract]:Objective: to establish the right stellate ganglion block model and cardiopulmonary bypass (CPB) model in rats, to detect the expression of caspase-3mRNA and protein in hippocampus of rats after CPB, and to investigate whether CPB can damage the hippocampus of rats. To observe the effect of right SGB on the expression of caspase-3mRNA and protein in hippocampus of rats after CPB, and to explore the protective effect of right SGB on the brain injury of CPB and its related mechanism. Methods: forty SPF SD rats were randomly divided into group S (n = 10), group R (n = 10), group C (n = 10) and group RC (n = 4). Right stellate ganglion block and cardiopulmonary bypass group. Group C: cardiopulmonary bypass group. Group RC: right stellate ganglion block plus cardiopulmonary bypass group. Group R and RC group with 0.25% cloth. The right stellate ganglion block group (group C) and group RC (group RC) were treated with right stellate ganglion block (right stellate ganglion block) after 1 hour of cardiopulmonary bypass (CPB). After successful intubation was performed in group 3h.R (group S), the experiment was terminated for 4 hours. The vital signs, blood gas and so on were monitored during the experiment. At the end of the experiment, the hippocampal tissues of the rats were separated quickly, and some of them were stored at -80 鈩

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