乌司他丁和地塞米松对心肺脑复苏早期大鼠脑组织含水量及IL-1β水平等的影响

The effect of ulinastatin and dexamethasone on the water content and levels of IL-1β in rat brain tissues and peripheral blood TNF-α during early stage of cardiopulmonary resuscitation

目的探讨乌司他丁、地塞米松以及两者联合应用对心肺脑复苏早期大鼠脑组织含水量及脑组织IL-1β、外周血肿瘤坏死因子α(TNF-α)含量的影响。方法将40只SD大鼠随机分为假手术对照组、心肺脑复苏(CPCR)组、地塞米松组、乌司他丁组、乌司他丁+地塞米松组,每组各8只大鼠。采用夹闭气管法建立大鼠心肺脑复苏模型。于自主呼吸循环恢复后2h,采用干湿法检测各组大鼠脑组织含水量,采用放射免疫法检测大鼠脑组织IL-1β和外周血TNF-α水平。结果①脑组织含水量:CPCR组为(80.4±2.0)%,较对照组(76.7±1.3)%显著增加(P<0.01);乌司他丁组、地塞米松组、乌司他丁+地塞米松组,3组间差异无统计学意义(P>0.05),但均较CPCR组显著减少(P<0.01)。②脑组织IL-1β含量:CPCR组为(0.235±0.051)ng/mg,较对照组(0.108±0.020)ng/mg明显增高(P<0.01);地塞米松组、乌司他丁组与CPCR组比较,差异无统计学意义;乌司他丁+地塞米松组IL-1β含量为(0.065±0.021)ng/mg,明显低于CPCR组(0.235±0.051)ng/mg(P<0.001)。③外周血TNF-α水平:CPCR组为(3.07±0.74)ng/ml,较对照组(1.03±0.51)ng/ml明显增高(P<0.01);乌司他丁组、地塞米松组、乌司他丁+地塞米松组均比CPCR组显著降低(P<0.01),但3组间差异无统计学意义(P>0.05)。结论CPCR早期即可发生脑水肿,脑组织IL-1β及外周血TNF-α水平显著增加;应用乌司他丁、地塞米松能有效降低脑组织含水量、IL-1β和外周血中TNF-α水平。

Objective To ohserve the effect of ulinastatin （ UTI）, dexamethasone （DXM） and both on the content, levels of interlukin-1β（IL-1β） in rat hrain tissues and peripheral hlood tumor necrosis factor-α （TNF-α） during early stage of cardiopulmonary resuscitation. Methods Forty SD rats were randomly assigned to sham-operation （control）, cardiopulmonary cerehral resuscitation （CPCR）, DXM, UTI and UTI ＋ DXM groups （n =8 in each group）. A rat model of cardiopulmonary resuscitation was established by clipping rat trachea. Two hours after restoration of spontaneous respiration and circulation, the water content in brain tissues was detected by dry and wet method, and the levels of IL-1β in brain tissues and peripheral blood TNF-α were detected by radioimmunoassay in all groups. Results The brain water content in the CPCR group was significantly higher than that in the control group （ 80. 4 ± 2.0% vs. 76. 7 ± 1.3%, P〈0.01） , and there wereno significant differences among the DXM, UTI and UTI ＋ DXM groups, but their brain water content was all significantly decreased than that in the CPCR group （ P 〈 0.0l）. The levels of IL-1β in brain tissues in the CPCR group increased significantly than those in the control group （0. 235 ± 0. 051 ng/mg vs. 0. 108 ± 0. 020 ng/mg, P 〈0.01 ）, and there were no significant differences in the DXM and UTI groups as compared with the CPCR group; the levels of IL-1β in the UTI ＋ DXM group were significantly lower than those in the CPCR group （0. 065 ± 0. 021 ng/mL vs. 0. 235 ±0. 051 ng/mL, P 〈0. 001 ）. The levels of peripheral blood TNF-α in the CPCR group were significantly higher than those in the control group （3.07 ± 0. 74 ng/mL vs. 1.03 ± 0. 51 ng/mL, P 〈0. 01 ） ; the levels of peripheral blood TNF-α in the DXM, UTI and UTI ＋ DXM groups were significantly lower than those in the CPCR group （ P 〈 0.01 ）, but there were no significant differences among the three groups. Conclusion Brain edema occurs during the early stage of CPCR, and the levels of IL-1β and peripheral blood TNF-α in brain tissues increase significantly. The use of UTI and DXM may effectively reduce the brain water content, the levels of IL-1β in brain tissues and peripheral blood TNF-α.