| 李 玄,马新宇,张桂梅,佟可欣,霍 星,王国年,张崇友.HTEA对全脑缺血/再灌注大鼠脑血流及海马细胞凋亡的影响[J].,2017,17(25):4824-4827 |
| HTEA对全脑缺血/再灌注大鼠脑血流及海马细胞凋亡的影响 |
| Effects of High Thoracic Epidural Anesthesia on Cerebral Blood Flow and Hippocampal Apoptosis during Global Cerebral Ischemia and Reperfusion in Rats |
| 投稿时间：2016-12-11 修订日期：2017-01-06 |
| DOI：10.13241/j.cnki.pmb.2017.25.006 |
| 中文关键词: 上胸段硬膜外阻滞 全脑缺血再灌注 脑血流 低灌注期 凋亡相关蛋白 |
| 英文关键词: High thoracic epidural anesthesia (HTEA) Global cerebral ischemia and reperfusion Cerebral blood flow Hypoperfusion Apoptosis-related proteins |
| 基金项目:黑龙江省教育厅基金项目（12541418） |
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| 中文摘要: |
| 摘要 目的：研究上胸段硬膜外阻滞（high thoracic epidural anesthesia，HTEA）对大鼠全脑缺血再灌注损伤（global cerebral ischemia，GCI）再灌注期间脑血流及凋亡相关蛋白Bcl-2和Bax的影响。方法：本研究选用成年雄性Wistar大鼠成功进行T4-5间隙硬膜外置管，并建立四血管阻断的全脑缺血模型进行15 min的全脑缺血。根据通过硬膜外导管输注药物不同，随机分为四组：假手术组（Sham，0.9 %生理盐水）、假手术-硬膜外组（Sham-HTEA，0.25 %布比卡因）、全脑缺血组（GCI，0.9 %生理盐水）和硬膜外组（HTEA，0.25 %布比卡因）。给药时间从缺血前15 min开始以20 μL/h的速度持续输注至再灌注24 h。缺血前至再灌注2 h观察平均动脉压（MAP）和心率（HR），激光多普勒血流仪监测脑血流（cerebral blood flow，CBF），Western-blot检测再灌注24 h海马凋亡蛋白Bcl-2和Bax含量。结果：HTEA组与GCI组相比，缺血期间及再灌注2 h内的MAP和HR无统计学差异，而与Sham组相比，GCI组的MAP缺血时升高，而再灌注时降低（P<0.05）；再灌注10 min的高灌注期HTEA组CBF明显低于GCI组（123.1% ± 35.2% vs 177.5%±32.4%，P<0.01），再灌注60 min至120 min的低灌注期的大部分时间点HTEA组CBF均高于GCI组（P<0.05）；再灌注24 h海马组织Bax/Bcl-2比例明显降低（P<0.01）。结论：0.25 %的布比卡因20 μL?h-1连续上胸段硬膜外阻滞可以维持血流动力学稳定，且可改善大鼠全脑缺血再灌注后低灌注期的脑血流量，并减少再灌注24 h海马Bax/Bcl-2比例。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the effects of high thoracic epidural anesthesia (HTEA) on the cerebral blood flow (CBF) and hippocampal apoptosis-related proteins Bcl-2 and Bax during global cerebral ischemia and reperfusion (GCI) in rats. Methods: Fifteen-minute global ischemia was established by 4-vessel occlusion and epidural catheterization was performed through T4-5 intervertebral spaces in adult male Wistar rats. According to the different drugs infused into the epidural space, the rats were randomly divided into four groups: Sham group (0.9 % NaCl), Sham-HTEA group (0.25 % bupivacaine), GCI group (global cerebral ischemia, 0.9 % NaCl) and HTEA group (global cerebral ischemia, 0.25 % bupivacaine). And 0.25 %bupivacaine or 0.9 % saline (20 μL?h-1) was infused continuously to the thoracic epidural space from 15 minutes before ischemia to 24 hours after reperfusion. Mean arterial pressure (MAP), heart rate (HR) and cerebral blood flow (CBF) were determined until 2 hours after reperfusion, and the hippocampal Bcl-2 and Bax proteins at 24 hours after reperfusion were examined by Western-blot. Results: Compared with the GCI group, HTEA group has no significant difference on MAP and HR during ischemia and 2 hours after reperfusion, andcompared with the Sham group, MAP in GCI group increased in ischemia 0 min and decreased in reperfusion 0 min. The CBF in HTEA group was significantly lower than that in GCI group(123.1%±35.2% vs 177.5%±32.4%, P<0.01) in reperfusion 10 min, and higher than that in GCI group during the hypoperfusion of 60 to 120 minutes after reperfusion (P<0.05), and the ratio of Bax/Bcl-2 in hippocampus was significantly decreased in HTEA group 24 hours after reperfusion (P<0.01). Conclusion: Continuous HTEA infusion of 0.25 % bupivacaine 20 μL?h-1 could maintain the hemodynamic stability, and improve the CBF of hypoperfusion period in rats, as well as reduce the ratio of Bax/Bcl-2 at 24 hours after reperfusion. |
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