【摘要】：目的制備穩(wěn)定的大鼠大腦中動(dòng)脈阻塞（MCAO）線栓模型，初步探討無創(chuàng)性肢體缺血后適應(yīng)（RPC）對(duì)大鼠急性期腦缺血損傷是否具有保護(hù)作用，并從凋亡及炎癥兩方面初步探討其機(jī)制。 方法90只健康雄性SD大鼠（體重260g~280g），隨機(jī)分為5組：1假手術(shù)組（Sham組）：單純暴露血管，不行插線缺血操作、不進(jìn)行無創(chuàng)性肢體缺血后適應(yīng)干預(yù)。2缺血2h再灌注組（I/R組）：大鼠MCAO2h再灌注24h，不給予無創(chuàng)性RPC，不阻斷雙側(cè)后肢股動(dòng)脈血流。3缺血原位后適應(yīng)組（IP組）：在大鼠MCAO2h再灌注開始的同時(shí)將魚線拔出5mm，恢復(fù)腦血流20s，再插線放進(jìn)5mm，阻塞血流20s，循環(huán)3次，再灌注24h。4缺血即刻后適應(yīng)組（I-RPC組）：在大鼠MCAO制備過程中線栓成功阻塞大鼠MCA的同時(shí)給予無創(chuàng)性RPC，缺血2h以后再灌注24h。5再灌注即刻后適應(yīng)組（R-RPC組）：大鼠MCAO2h后于拔出線栓的同時(shí)立即給予無創(chuàng)性RPC。無創(chuàng)性RPC的方法是：用止血帶結(jié)扎大鼠雙側(cè)后肢根部阻斷雙側(cè)股動(dòng)脈血流，以不能觸及股動(dòng)脈搏動(dòng)為缺血成功標(biāo)志，止血帶結(jié)扎10min，放開10min，如此循環(huán)3次。各組大鼠分別于再灌注24h行神經(jīng)功能評(píng)分，評(píng)分結(jié)束后處死大鼠，采用干濕稱重法測腦含水量、TTC染色計(jì)算腦梗死體積、HE染色光鏡觀察形態(tài)學(xué)、TUNEL法測凋亡細(xì)胞、免疫組化方法檢測超敏C反應(yīng)蛋白（Hs-CRP）水平。 結(jié)果1線栓法成功建立大鼠MCAO缺血再灌注模型；2與I/R組相比，IP組、I-RPC組、R-RPC組大鼠神經(jīng)功能評(píng)分有所改善（P0.05），海馬區(qū)凋亡神經(jīng)元數(shù)目減少（P0.05），腦水腫程度減輕（P0.05），缺血側(cè)腦梗死體積減少（P0.05），海馬區(qū)神經(jīng)元病理改變程度改善（P0.05），海馬區(qū)Hs-CRP表達(dá)水平降低（P0.05）；但I(xiàn)P組、I-RPC組、R-RPC組3組之間兩兩比較無統(tǒng)計(jì)學(xué)意義（P0.05）。 結(jié)論本研究通過建立了穩(wěn)定的大鼠大腦中動(dòng)脈線栓模型，，證實(shí)無創(chuàng)性遠(yuǎn)隔肢體缺血后適應(yīng)對(duì)大鼠急性腦缺血具有神經(jīng)保護(hù)作用，其機(jī)制可能是通過降低海馬區(qū)神經(jīng)元凋亡程度及抑制炎癥反應(yīng)（Hs-CRP的表達(dá)）來實(shí)現(xiàn)的。
[Abstract]:Objective to establish a stable model of middle cerebral artery occlusion (MCAO) with (MCAO) thread embolus in rats and to explore the protective effect of adaptive (RPC) after noninvasive limb ischemia on acute cerebral ischemia injury in rats. The mechanism of apoptosis and inflammation were also discussed. Methods 90 healthy male SD rats (weight 260g~280g) were randomly divided into 5 groups: 1sham operation group (Sham group): exposure of blood vessels only, but no ischemia operation by inserting thread, the rats were divided into 5 groups at random: 1 sham operation group (Sham group); (2) ischemia 2 h reperfusion group (I R group): MCAO2h reperfusion for 24 h, no noninvasive RPC, was given to rats. The blood flow of femoral artery in both hind limbs was not blocked. 3After ischemia in situ group (IP group): at the beginning of reperfusion of MCAO2h in rats, the fish line was pulled out 5 mm, the cerebral blood flow was restored to 20 s, then inserted into 5 mm, the occluded blood flow was 20 s, circulation was 3 times. Reperfused 24h.4 immediately after ischemia group (I-RPC group): non-invasive RPC, was administered simultaneously with successful occlusion of rat MCA during the preparation of MCAO in rats. Group R-RPC: rats were treated with non-invasive RPC. immediately after reperfusion of 24h.5 after 2 hours of ischemia (R-RPC group). After MCAO2h was removed, non-invasive RPC. was given immediately at the same time as the wire thrombus was pulled out. The method of non-invasive RPC was to block the blood flow of bilateral femoral artery by ligating the root of bilateral hind limbs of rats with tourniquet, which could not touch the pulsatile of femoral artery as a successful sign of ischemia. The tourniquet was ligated for 10 minutes and released for 10 minutes, so that the circulation was three times. After 24 hours of reperfusion, the rats in each group were sacrificed. The brain water content was measured by dry-wet weighing method, the infarct volume was calculated by TTC staining, the morphology was observed by HE staining, and the apoptotic cells were measured by TUNEL method. The level of hypersensitive C-reactive protein (Hs-CRP) was detected by immunohistochemistry. Results 1the ischemia-reperfusion model of MCAO was successfully established by thread embolus method in rats. 2Compared with I / R group, IP group, I-RPC group and R-RPC group improved the scores of neural function (P0.05), decreased the number of apoptotic neurons in hippocampus (P0.05), and reduced the degree of brain edema (P0.05). The infarct volume of ischemic side was decreased (P0.05), the degree of neuronal pathological changes in hippocampus was improved (P0.05), and the expression of Hs-CRP in hippocampus was decreased (P0.05). But there was no significant difference among IP group, I-RPC group and R-RPC group (P0.05). Conclusion in this study, we established a stable model of middle cerebral artery occlusion in rats, and confirmed the neuroprotective effect of adaptation after non-invasive distal limb ischemia on acute cerebral ischemia in rats. The mechanism may be achieved by decreasing the degree of apoptosis and inhibiting the expression of Hs-CRP in hippocampal neurons.
【學(xué)位授予單位】：河北聯(lián)合大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R743.3

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