缺血缺氧性脑损伤中一氧化氮合酶的作用

Effects of nitricoxide synthase in ischemic-hypoxic brain injury

目的:一氧化氮在脑缺血缺氧时是一种重要并且具有复杂作用的损伤因子,但由于一氧化氮不仅在脑缺血及再灌注中有量的增加,而且在不同的脑缺血模型中作用也不尽相同,文章旨在探讨一氧化氮在缺血缺氧性脑损伤中的作用。资料来源:应用计算机检索Medline数据库1980-01/2005-01的相关文章,检索词为“cerebralischemia,cerebralanoxia,nitricoxidesynthase”,分别组合进行检索,限定文章语言种类为英文。同时计算机检索中国期刊全文数据库、万方数据库1994-01/2005-05的相关文章,检索词“脑缺血,脑缺氧,一氧化氮合酶”,限定文章语言种类为中文。资料选择:对资料进行初审,选取实验包括上述干预组和对照组的文献,筛除非随机的实验,对剩余的文献开始查找全文,以随机对照实验作为纳入标准。排除综述和重复性文章。资料提炼:共收集到56篇关于缺血缺氧性脑损伤中一氧化氮合酶的作用的随机和未随机试验,30个试验符合纳入标准,排除20篇重复性实验,6篇综述。资料综合:30个试验干预措施选用了脑缺血缺氧性损伤中3种一氧化氮合酶的神经毒性作用与神经保护性作用,其中位于神经元中的神经元型一氧化氮合酶具有神经毒性作用,位于大脑内皮细胞中的内皮型一氧化氮合酶具有神经保护作用,位于炎性细胞和胶质细胞中的诱导型一氧化氮合酶既有神经毒性作用又有神经保护作用。结论:一氧化氮合酶在缺血缺氧性脑损伤中起重要的调节作用,可以通过不同类型的一氧化氮合酶的表达诊断缺血缺氧性脑损伤的进展程度及损伤情况,并且针对不同阶段利用一氧化氮合酶选择性抑制剂,一氧化氮合酶相关基因敲除技术以及RNA干扰技术等,发挥其调节和脑保护作用。

OBJECTIVE： Nitrogen manoxide is an important and a damage factor which has complicated function, but because nitrogen monoxide not only increase in eerebral ischemia and re-instillation, but also its function in different cerebral ischemia model is still different. This article is to explore the effect of nitrogen monoxide on ischemic hypoxia brain injury. DATA SOURCES： The relative articles were searched in Medline database published from January 1980 to January 2005, using the keywords “cerebral ischemia,cerebral anoxia,nitric oxide synthase”, assembled respectively to search with the language limited to English. Meanwhile, we searched the China Journal Full-text Database and Wanfang database for relative articles published from January 1994 to May 2005, using the keywords “cerebral ischemia,cerebral anoxia,nitric oxide synthase” with the language limited to Chinese. STUDY SELECTION： After the first trial, the experiments included the above-mentioned literatures of intervention group and control group were selected, and those non-randomized trials were excluded. The rest literatures were searched for full texts, taking control trial as inclusion criteria. Those review and repeated articles were excluded. DATA EXTRACTION： Totally 56 articles of randomized and non- randomized trial about the action of nitricoxide synthase （NOS） in ischemia and hypoxia brain injury were collected, and 30 trials were coincidence with inclusion criteria. Twenty repeated trials and six reviews were excluded. DATA SYNTHESIS： The intervention study in 30 trials, neurotoxieity action and nerve protective action of three NOS in cerebral ischemia and hypoxia injury, were used. Among them, neuron NOS in neuron had neurotoxicity action, and endothelium NOS in cerebrum endothelial cell had nerve protective action, and induction NOS in inflamed cell and glial cell had also nerve protective action. CONCLUSION： NOS plays significant role in ischemic hypoxia brain injury. The development degree and damage condition of ischemic hypoxia brain injury can be diagnosed by different type of the expression of NOS. Moreover, aiming at different stages, selective NOS inhibitor, correlative gene knock-out technique of NOS and RNA interaction technique etc. were applied to full play its adjustment and brain protective effect.