去骨瓣減壓對大鼠心肺復(fù)蘇后大腦中動脈血流、S100b及NSE蛋白表達(dá)的影響
發(fā)布時間：2018-08-13 08:33
【摘要】：目的研究去骨瓣減壓術(shù)對窒息性心臟驟停大鼠復(fù)蘇腦神經(jīng)元特異性烯醇化酶(NSE)、S-100b蛋白(S-100)表達(dá)及腦血流量的影響,探討去骨瓣減壓對窒息性心跳驟停大鼠復(fù)蘇腦所產(chǎn)生的保護(hù)作用以及產(chǎn)生這種保護(hù)作用的可能機(jī)制,為窒息性心跳驟停的臨床治療提供理論依據(jù)。方法1實(shí)驗(yàn)動物及分組成年清潔雄性Wistar大鼠48只,體重250~370 g,隨機(jī)分為假手術(shù)組、復(fù)蘇組、去骨瓣組,再分別按氣管插管+股動靜脈置管術(shù)后(假手術(shù)組)或自主循環(huán)恢復(fù)(ROSC)后(復(fù)蘇組、去骨瓣組)分為6 h亞組,12 h亞組,24 h亞組,48 h亞組這4個亞組,每個亞組4只。實(shí)驗(yàn)之前大鼠禁食至少12 h,但不禁水。2實(shí)驗(yàn)?zāi)Ｐ椭谱鞑捎酶牧夹偷闹舷⒎ㄖ苽浯笫笮呐K驟停復(fù)蘇模型。復(fù)蘇組與去骨瓣干預(yù)組采用窒息致大鼠心臟驟停(CA)和心肺復(fù)蘇(CPR)模型。去骨瓣干預(yù)組在大鼠心肺復(fù)蘇術(shù)成功后1h施行去骨瓣減壓術(shù)。假手術(shù)組僅行氣管插管、股動靜脈置管術(shù)。3去骨瓣干預(yù)治療去骨瓣各亞組(6 h,12 h,24 h,48 h)大鼠于窒息性心跳驟停復(fù)蘇模型成功1小時后行去骨瓣干預(yù)。4術(shù)后大腦中動脈血流的監(jiān)測各亞組大鼠分別按照時間點(diǎn),于6h、12h、24h及48h后,使用激光多普勒血流儀(LDF)監(jiān)測大鼠心肺復(fù)蘇前后大腦中動脈血流的變化。5標(biāo)本的采集在不同的時間點(diǎn)取大鼠靜脈血,離心留取血清,采用Elisa方法,檢測血清中NSE和S100b蛋白的表達(dá),然后斷頭取腦,行HE染色,分析各實(shí)驗(yàn)指標(biāo)與去骨瓣減壓術(shù)的相關(guān)性。6統(tǒng)計學(xué)方法文中數(shù)據(jù)均以(均數(shù)±標(biāo)準(zhǔn)差)表示,應(yīng)用SPSS 17.0統(tǒng)計學(xué)軟件對本實(shí)驗(yàn)數(shù)據(jù)進(jìn)行分析,組間比較采用單因素方差分析,組內(nèi)比較采用卡方檢驗(yàn)。結(jié)果以P0.05為差異具有統(tǒng)計學(xué)意義。結(jié)果1假手術(shù)組各亞組大鼠氣管插管及動靜脈置管前后大腦中動脈血流無明顯異常變化。與假手術(shù)組比較,復(fù)蘇組、去骨瓣干預(yù)組大腦中動脈血流在自主循環(huán)恢復(fù)(ROSC)后6h降低,而且會持續(xù)降低至48h,實(shí)驗(yàn)結(jié)果的差異具有統(tǒng)計學(xué)上的意義(P0.05);與復(fù)蘇組比較,去骨瓣干預(yù)組大腦中動脈血流在自主循環(huán)恢復(fù)(ROSC)后6h至48h降低幅度較小,6h、12h、24h、48h的實(shí)驗(yàn)結(jié)果差異有顯著性(P0.05)。2血清中NSE蛋白的濃度:與假手術(shù)組比較,復(fù)蘇組及去骨瓣減壓組血清NSE蛋白在自主循環(huán)恢復(fù)(ROSC)后6h明顯升高,而且會持續(xù)上升至12 h達(dá)到峰值,在24 h和48h有所回落,差異具有統(tǒng)計學(xué)意義(P0.01);去骨瓣減壓組與復(fù)蘇組比較,去骨瓣減壓組ROSC后6 h血清內(nèi)NSE蛋白濃度較復(fù)蘇組無明顯差異,沒有統(tǒng)計學(xué)上的意義(P0.05)然而實(shí)驗(yàn)12 h、24 h和48h后血清中NSE蛋白的濃度較復(fù)蘇組明顯降低,而且差異具有高度的顯著性(P0.01)。3血清中S100b蛋白的濃度:與假手術(shù)組比較,復(fù)蘇組及去骨瓣減壓組血清S100b蛋白在自主循環(huán)恢復(fù)(ROSC)后6h明顯升高,而且會持續(xù)上升到12 h達(dá)峰值,在24 h、48h時有所回落,差異高度顯著,具有統(tǒng)計學(xué)意義(P0.01);去骨瓣減壓組與復(fù)蘇組比較,去骨瓣減壓組在ROSC后6 h、12 h、24 h、48h時血清中S100b蛋白的濃度明顯較復(fù)蘇組減低,而且差異具有高度的顯著性(P0.01)。結(jié)論去骨瓣減壓能改善心肺復(fù)蘇后大腦中動脈血流速度,并且可以使大鼠心肺復(fù)蘇術(shù)后血清中NSE、S100b蛋白的表達(dá)降低,從而減輕顱腦的損傷。
[Abstract]:Objective To study the effect of decompression of bone flap on the expression of neuron-specific enolase (NSE), S-100b protein (S-100) and cerebral blood flow in the resuscitated brain of rats with asphyxiated cardiac arrest, and to explore the protective effect of decompression of bone flap on the resuscitated brain of rats with asphyxiated cardiac arrest and the possible mechanism. Methods 1 Experimental animals and 48 clean male Wistar rats weighing 250-370 g were randomly divided into sham-operation group, resuscitation group and bone flap removal group, and then divided into 6 groups according to tracheal intubation plus femoral artery and vein catheterization (sham-operation group) or autonomic circulation recovery (ROSC) respectively. Before the experiment, rats were fasting for at least 12 hours, but water was not forbidden. 2 The model of cardiac arrest resuscitation was made by modified asphyxia. The resuscitation group and the debridement intervention group were made by asphyxia-induced cardiac arrest (CA) and cardiopulmonary resuscitation (CPR) models. The sham operation group was treated with tracheal intubation and femoral artery and vein catheterization. 3 The bone flap intervention was performed in each subgroup (6 h, 12 h, 24 h, 48 h). The changes of middle cerebral artery blood flow were monitored by laser Doppler flowmeter (LDF) at 6 h, 12 h, 24 h and 48 h after CPR in each subgroup. HE staining was used to analyze the correlation between the experimental indexes and decompression. 6 Statistical methods The data in this paper were expressed as mean (+ standard deviation). SPSS 17.0 statistical software was used to analyze the experimental data. One-way ANOVA was used to compare the data between groups. Chi-square test was used to compare the results between groups. Results 1 There were no significant changes in the middle cerebral artery blood flow before and after tracheal intubation and arteriovenous catheterization in the sham operation group. Compared with the sham operation group, the middle cerebral artery blood flow in the resuscitation group and the debridement intervention group decreased 6 hours after the recovery of spontaneous circulation (ROSC) and continued to decrease to 48 hours after the recovery of ROSC. Compared with the resuscitation group, the blood flow of middle cerebral artery in the debridement group decreased slightly from 6 hours to 48 hours after the recovery of spontaneous circulation (ROSC), and the experimental results showed significant difference (P 0.05). 2 Serum NSE protein concentration in the debridement group and the resuscitation group was significantly lower than that in the sham operation group (P 0.05). Compared with the resuscitation group, there was no significant difference in serum NSE protein concentration between the decompression group and the resuscitation group (P 0.05). However, the serum levels of NSE protein were significantly lower at 12, 24 and 48 hours than those in the resuscitation group (P 0.01). 3 Serum levels of S100b protein were significantly different (P 0.01). Compared with the resuscitation group, the serum concentration of S100b protein in the decompression group was significantly lower than that in the resuscitation group at 6 h, 12 h, 24 h and 48 h after ROSC, and the difference was highly significant (P 0.01). The blood flow velocity of the middle cerebral artery after cardiopulmonary resuscitation decreased the expression of NSE and S100b proteins in the serum of rats after cardiopulmonary resuscitation, thus reducing the brain injury.
【學(xué)位授予單位】：華北理工大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R651.1
本文編號：2180439
[Abstract]:Objective To study the effect of decompression of bone flap on the expression of neuron-specific enolase (NSE), S-100b protein (S-100) and cerebral blood flow in the resuscitated brain of rats with asphyxiated cardiac arrest, and to explore the protective effect of decompression of bone flap on the resuscitated brain of rats with asphyxiated cardiac arrest and the possible mechanism. Methods 1 Experimental animals and 48 clean male Wistar rats weighing 250-370 g were randomly divided into sham-operation group, resuscitation group and bone flap removal group, and then divided into 6 groups according to tracheal intubation plus femoral artery and vein catheterization (sham-operation group) or autonomic circulation recovery (ROSC) respectively. Before the experiment, rats were fasting for at least 12 hours, but water was not forbidden. 2 The model of cardiac arrest resuscitation was made by modified asphyxia. The resuscitation group and the debridement intervention group were made by asphyxia-induced cardiac arrest (CA) and cardiopulmonary resuscitation (CPR) models. The sham operation group was treated with tracheal intubation and femoral artery and vein catheterization. 3 The bone flap intervention was performed in each subgroup (6 h, 12 h, 24 h, 48 h). The changes of middle cerebral artery blood flow were monitored by laser Doppler flowmeter (LDF) at 6 h, 12 h, 24 h and 48 h after CPR in each subgroup. HE staining was used to analyze the correlation between the experimental indexes and decompression. 6 Statistical methods The data in this paper were expressed as mean (+ standard deviation). SPSS 17.0 statistical software was used to analyze the experimental data. One-way ANOVA was used to compare the data between groups. Chi-square test was used to compare the results between groups. Results 1 There were no significant changes in the middle cerebral artery blood flow before and after tracheal intubation and arteriovenous catheterization in the sham operation group. Compared with the sham operation group, the middle cerebral artery blood flow in the resuscitation group and the debridement intervention group decreased 6 hours after the recovery of spontaneous circulation (ROSC) and continued to decrease to 48 hours after the recovery of ROSC. Compared with the resuscitation group, the blood flow of middle cerebral artery in the debridement group decreased slightly from 6 hours to 48 hours after the recovery of spontaneous circulation (ROSC), and the experimental results showed significant difference (P 0.05). 2 Serum NSE protein concentration in the debridement group and the resuscitation group was significantly lower than that in the sham operation group (P 0.05). Compared with the resuscitation group, there was no significant difference in serum NSE protein concentration between the decompression group and the resuscitation group (P 0.05). However, the serum levels of NSE protein were significantly lower at 12, 24 and 48 hours than those in the resuscitation group (P 0.01). 3 Serum levels of S100b protein were significantly different (P 0.01). Compared with the resuscitation group, the serum concentration of S100b protein in the decompression group was significantly lower than that in the resuscitation group at 6 h, 12 h, 24 h and 48 h after ROSC, and the difference was highly significant (P 0.01). The blood flow velocity of the middle cerebral artery after cardiopulmonary resuscitation decreased the expression of NSE and S100b proteins in the serum of rats after cardiopulmonary resuscitation, thus reducing the brain injury.
【學(xué)位授予單位】：華北理工大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R651.1
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