【摘要】：目的 探討腦血流監(jiān)測(cè)對(duì)線栓法制備大鼠大腦中動(dòng)脈阻塞(MCAO)局灶性腦缺血模型的評(píng)價(jià)作用。方法 分別將線栓插入30只SPF級(jí)Wistar Han大鼠頸內(nèi)動(dòng)脈顱內(nèi)段(16.0±0.5)、(18.0±0.5)和(20.0±0.5)mm,制備3種局灶性腦缺血模型(各10只),然后將所有實(shí)驗(yàn)大鼠依據(jù)顱底有無血凝塊及2,3,5氯化三苯基四氮(TTC)染色后大腦中動(dòng)脈供血區(qū)有無梗死灶分為不全阻塞組、完全阻塞組及過深阻塞組,對(duì)阻塞頸內(nèi)動(dòng)脈顱內(nèi)段前后及拔出線栓再灌注后每只大鼠大腦中動(dòng)脈供血區(qū)腦皮質(zhì)的血流量以激光多普勒法進(jìn)行監(jiān)測(cè)記錄并進(jìn)行統(tǒng)計(jì)學(xué)分析。大腦中動(dòng)脈供血區(qū)腦皮質(zhì)的血流量以相對(duì)流量單位PU值表示;阻塞后及再灌注后的腦皮質(zhì)血流量變化以與阻塞前腦皮質(zhì)血流量的百分比表示。結(jié)果 模型制作過程中,1只大鼠死亡;不全阻塞組9只,完全阻塞組15只,過深阻塞組5只。不全阻塞組8只大鼠線栓插入深度在(16.0±0.5)mm,不能完全阻止大腦前動(dòng)脈向大腦中動(dòng)脈的血流,缺血6 h后大鼠Longa評(píng)分0~1分;顱底動(dòng)脈環(huán)周圍無血凝塊,經(jīng)TTC染色后無梗死灶。完全阻塞組9只大鼠線栓插入深度在(18.0±0.5)mm,大腦前動(dòng)脈的血流被完全阻斷,缺血6 h后大鼠Longa評(píng)分2~3分;顱底動(dòng)脈環(huán)周圍無血凝塊而TTC染色提示存在大腦中動(dòng)脈供血區(qū)的梗死灶。過深阻塞組5只大鼠線栓插入深度在(20.0±0.5)mm,可完全阻斷大腦前動(dòng)脈血流,缺血6 h后大鼠Longa評(píng)分3~4分;解剖可見顱底血凝塊,TTC染色后可見中動(dòng)脈供血區(qū)梗死灶。插入線栓后,不全阻塞組、完全阻塞組和過深阻塞組大鼠腦皮質(zhì)血流量均較阻塞前下降(分別為94±17比256±36、43±9比286±44、44±6比294±46,均P0.05),組間差異有統(tǒng)計(jì)學(xué)意義(F=56.57,P0.01),完全阻塞組和過深阻塞組血流量明顯低于不全阻塞組(均P0.05),完全阻塞組與過深阻塞組間差異無統(tǒng)計(jì)學(xué)意義(P0.05);3組阻塞后與阻塞前腦皮質(zhì)血流量的百分比分別為(36.93±0.06)%、(15.09±0.02)%、(15.52±0.04)%,組間差異有統(tǒng)計(jì)學(xué)意義(F=39.14,P0.01)。再灌注后,不全阻塞組、完全阻塞組和過深阻塞組腦皮質(zhì)血流量(分別為213±31、147±17、96±14)均較阻塞后有明顯回升(均P0.05),組間差異有統(tǒng)計(jì)學(xué)意義(F=50.05,P0.01),過深阻塞組腦皮質(zhì)血流量明顯低于完全阻塞組(P0.05);3組再灌注后與阻塞前腦皮質(zhì)血流量水平百分比分別為(83.10±0.02)%、(51.83±0.05)%、(33.49±0.09)%,差異有統(tǒng)計(jì)學(xué)意義(F=93.23,P0.01)。結(jié)論 以激光多普勒對(duì)腦血流進(jìn)行監(jiān)測(cè),可作為判斷線栓法制備大鼠MCAO腦缺血模型成功與否的一種實(shí)時(shí)、便捷、微創(chuàng)、客觀可靠的評(píng)價(jià)手段。
[Abstract]:Objective to evaluate the effect of cerebral blood flow monitoring on focal cerebral ischemia induced by middle cerebral artery occlusion (MCAO) in rats. Methods three kinds of focal cerebral ischemia models were established in 30 SPF grade Wistar Han rats by inserting them into the intracranial segment of the internal carotid artery (16.0 鹵0.5), (18.0 鹵0.5) and (20.0 鹵0.5) mm, respectively. Then all the experimental rats were divided into three groups: incomplete occlusion group, complete occlusion group and over-deep occlusion group, according to the presence of blood clots in the skull base and the presence or absence of infarction in the blood supply area of the middle cerebral artery (MCAA) after the staining of triphenyl tetrazolium chloride (TTC). The blood flow in the cerebral cortex of the middle cerebral artery in each rat was monitored and analyzed by laser Doppler method before and after the occlusion of the internal carotid artery and the reperfusion of the extracellular thrombus. The cortical blood flow in the middle cerebral artery (MCA) region was expressed as relative flow unit (PU), and the cortical blood flow after occlusion and reperfusion was expressed as the percentage of cerebral cortical blood flow (CBF) after occlusion and reperfusion. Results during the course of making the model, one rat died, 9 rats were in incomplete occlusion group, 15 rats in complete occlusion group and 5 rats in over-deep occlusion group. In the incomplete occlusion group, the insertion depth (16.0 鹵0.5) mm, could not completely prevent the anterior cerebral artery from flowing to the middle cerebral artery, and the Longa score of the rats was 0-1 after 6 hours of ischemia. There was no blood clot around the basilar artery ring and no infarct after TTC staining. In the complete occlusion group, the blood flow of the anterior cerebral artery was completely blocked at the depth of (18.0 鹵0.5) mm, and the Longa score of the rats was 2 ~ 3 points after 6 hours of ischemia. There was no blood clot around the basilar artery ring and TTC staining suggested that there was a infarct in the middle cerebral artery. At the depth of (20.0 鹵0.5) mm, the anterior cerebral artery blood flow could be completely blocked in the overdeep occlusion group. The Longa score of the rats was 3 ~ 4 points after 6 hours of ischemia, and the blood clot in the skull base could be seen at the anatomic level, and the infarcted area of the blood supply area of the middle artery could be seen after TTC staining. The cerebral cortical blood flow decreased significantly in the incomplete occlusion group, complete occlusion group and over-deep occlusion group (94 鹵17 vs 256 鹵36 鹵36 鹵43 鹵9 vs 286 鹵44 鹵6 vs 294 鹵46, respectively, P0.05), and the difference between the two groups was statistically significant (F 56.57 P0.01), and the cerebral cortical blood flow decreased significantly in the incomplete occlusion group, complete occlusion group and over-deep occlusion group (94 鹵17 vs 256 鹵36, 43 鹵9 vs 286 鹵44 鹵6 vs 294 鹵46, respectively, P0.05). The blood flow in the complete occlusion group and the deep occlusion group was significantly lower than that in the incomplete occlusion group (P0.05), but there was no significant difference between the complete occlusion group and the over-deep occlusion group (P0.05). The percentage of cerebral cortical blood flow after occlusion was (36.93 鹵0.06)%, (15.09 鹵0.02)%, (15.52 鹵0.04)%, respectively. After reperfusion, the cerebral cortical blood flow increased significantly (213 鹵31147 鹵1796 鹵14) in the incomplete occlusion group, complete occlusion group and over-deep occlusion group (P0.05), and the difference between the two groups was statistically significant (F0. 05 鹵0. 01). The cerebral cortical blood flow in the deep occlusion group was significantly lower than that in the complete occlusion group (P0.05). The percentage of cortical blood flow after reperfusion was (83.10 鹵0.02)%, (51.83 鹵0.05)%, (33.49 鹵0.09)%, respectively. The difference was statistically significant (F _ (93.23) P _ (0.01). Conclusion the monitoring of cerebral blood flow by laser Doppler can be used as a real-time, convenient, minimally invasive, objective and reliable method to evaluate the success of MCAO cerebral ischemia in rats.
【作者單位】： 新鄉(xiāng)醫(yī)學(xué)院第一附屬醫(yī)院神經(jīng)外科;
【分類號(hào)】：R-332;R743.3

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