迷走神经及其递质在大鼠脑出血致多器官功能障碍综合征中的作用

Effects of the vagus and its transmitter on multiple organ dysfunction syndrome induced by cerebral hemorrhage in rats

目的探讨迷走神经及其递质在大鼠脑出血(CH)致脑源性多器官功能障碍综合征(CMODS)中的作用。方法随机将80只Wistar大鼠分为假手术组(10只)、迷走神经切断(SDV)组(10只)、脑出血(CH)组(20只)、CH+SDV组(20只)和CH+迷走神经刺激(SIV)组(20只)。采用尾状核立体定向注射胶原酶和肝素钠制作CH大鼠模型,制模后出现肝功能、肾功能、心肌酶、血常规及生命体征异常达标的大鼠为CMODS模型。CH+SDV组大鼠在制模前4周行膈下SDV术;CH+SIV组大鼠在制模后行SIV,每次20min,每4h1次,共6次。各组大鼠于CH后24h行血常规、肝肾功能、心肌酶检查和主要脏器(肺、肝、肾、小肠)病理检查,用免疫组化法检测延髓内脏带(MVZ)内FOS蛋白、乙酰胆碱转移酶(CHAT)和血管活性肠肽(VIP)的表达,并与假手术组及SDV组比较。结果CH+SDV组、CH+SIV组和CH组的肝、肾功能,心肌酶异常程度以及肝、肾、小肠病理改变均重于假手术组和SDV组(均P<0.01);CH+SDV组又重于CH组(均P<0.01),而CH+SIV组明显轻于CH组(均P<0.05)。CH+SDV组的MVZ内FOS、CHAT、VIP阳性表达明显多于假手术组和SDV组,但明显少于CH组(均P<0.01);CH+SIV组明显多于CH组(均P<0.05)。结论迷走神经在CH致CMODS中对脏器有一定的保护作用;刺激迷走神经可减轻多器官损害程度,也使迷走神经递质表达增高,这可能是迷走神经保护作用的机制。

Objective To explore the effects of the vagus and its transmitter on cerebrogenic multiple organ dysfunction syndrome induced by cerebral hemorrhage （CH） in rats. Methods 80 wistar rats were randomly divided into sham-operative group （ n = 10 ） , subdiaphringmatic vagotomy （ SDV ） group （ n = 10 ） , CH group （ n=20 ）, CH ＋ SDV group （ n = 20） and CH ＋ SIV group （ n = 20）. Rat CH model was made by stereotaxis injection of collagenase and heparin sodium in caudate nucleus. The success full CMODS rat model was characterized by the abnormality of hepatic and renal function, myocardium enzyme, blood routine and vital sign of rat chalked standard. The rats of CH ＋ SDV group Were practiced SDV operation 4 weeks before the model was made. CH ＋ SIV group were put electrostimulation of vagus after the mode was made for 6 times. The stimulus continued 20 min with 4 h interval. All rats were executed 24 h after CH. The pathological change of main organs （liver, kidney, lung, small intestine） , blood routine were tested. Myocardium enzyme, hepatic and renal function were examinied. Meanwhile, the expression of FOS, CHAT and VIP in the medullary visceral zone of the rats were examined with immunohistochemistry, compared with the sham-operative group and SOV gruop. Results Abnormality of hepatic and renal function, myocardium enzyme and the pathological change of liver, kidney, small intestine CH ＋ SDV group, CH ＋ SIV group and those of CH group outweigh than sham-operative group and SDV group （ all P 〈 0. 01 ） ; CH ＋ SDV group outweighs than CH group （ all P 〈 0. 01 ）. CH ＋ SIV group were much lighter than those of CH group（ all P 〈 0. 05 ）. The positive expression of FOS, CHAT and VIP in MVZ of CH ＋ SDV group were much higher than those of sham-operative group and SDV group, but much fewer than those of CH group（ all P 〈 0. 01 ） ; CH ＋ SIV group were more than those of CH group （all P 〈 0.05 ）. Conclusions The vagus has some protective roles to organs in CMODS induced by CH. When the vagus is stimulated, the damaged degree of organs can be lessened and transmitter expression will be advanced,which may be mechanism of vagal protection.