多次给予羟乙基淀粉或高渗氯化钠溶液对实验性脑出血大鼠脑水肿的影响

Effects of repeated administrations of 6% hydroxyethyl starch or 7.5% NaCl on cerebral edema after intracerebral hemorrhage in rats

目的评价多次给予羟乙基淀粉或高渗氯化钠溶液对实验性脑出血（ICH）大鼠脑水肿的影响。方法清洁级雄性SD大鼠167只，体重260—300g，随机分为假手术组（S组，n=20）、ICH组（M组，n=38）、氯化钠组（N组，n=55）和羟乙基淀粉组（H组，n=54）。采用立体定向技术向大鼠右侧尾状核注入自体血50μl建立ICH模型，S组仅刺入基底节，但不注血。N组分别于ICH后2、24、48、72h前5—10min静脉输注7．5％氯化钠溶液5ml／kg，H组分别于ICH后2、24、48、72h前45～50min静脉输注6％羟乙基淀粉130／0．430ml／kg，速率均为0．2ml／min。S组和M组分别于ICH后2、24、48、72h随机取5只大鼠断头处死，N组和H组则在上述各时点输液前、后随机取5只大鼠处死，采用干湿重法测定脑含水量；各组每天行行为学评分，观察大鼠生存情况。结果与M组比较，N组和H组ICH后2、24、48、72h输液后注血侧皮层和基底节脑含水量、ICH后24、48h时行为学评分降低，ICH后24、48、72h时生存率升高（P〈0．05）；与N组比较，H组ICH后72h时生存率升高（P〈0．05）。结论多次给予6％羟乙基淀粉130／0．4或7．5％氯化钠溶液可改善ICH后大鼠脑水肿。

Objective To investigate the effects of repeated administrations of 6% hydroxyethyl starch （HES） 130/0.4 or 7.5% NaCl （NS） on brain water content （BWC） after experimental intracerebral hemorrhage （ICH） in rats. Methods One hundred and sixty-seven male SD rats weighing 260-300 g were randomly divided into 4 groups： group Ⅰ sham operation （S） （n=20）; group Ⅱ ICH （n=38）; group Ⅲ NS ＋ ICH （n=55） and group Ⅳ HES ＋ ICH （ n = 54）. The animals were anesthetized with intraperitoneal 10% chloral hydrate 400 mg/kg. Experimental ICH was produced by injection of fresh autologous blood 50 μl into right caudate nucleus. In group NS （group Ⅲ ） 7.5% NaCl 5 ml/kg and in group HES （group Ⅳ ） 6% HES 30 ml/kg were injected at 2, 24, 48 and 72 h after ICH. In group S and ICH （group Ⅰ and Ⅱ ） 5 animals were killed at 2, 24, 48 and 72 h after ICH, while in group Ⅲ （NS） and Ⅳ （HES） 5 animals were killed at 2, 24, 48 and 72 h after ICH, immediately before and after NS/HES infusion for determination of ipsilateral and contralateral cerebral cortex and basal ganglion, weight and W/D weight ratio. Rosenberger behavior scores and survival rates were also recorded. Results In group Ⅲ （NS ＋ ICH） and Ⅳ （ HES ＋ ICH） the water content of ipsilateral cerebral cortex and basal ganglion was significantly lower than in group Ⅱ （ICH）. Rosenberger behavior scores at 24 h and 48 h after ICH were significantly lower in group NS and HES than in groupⅡ （ICH）. The survival rates at 24, 48 and 72 h after ICH were significantly lower in group Ⅱ than in group NS and HES, especially at 72 h in group HES. Conclusion Repeated administrations of 6% HES 130/0.4 or 7.5% NaCl can ameliorate brain edema after ICH.