心脏骤停大鼠复苏后心脑ICAM-1和MMP-9的变化及药物治疗研究

Changes of intercellular adhesion molecule-1,matrix metalloproteinase-9 and the effects of drugs after cardiopulmonary cerebral resuscitation rats

目的探讨窒息至心脏骤停大鼠复苏后心脑ICAM-1和MMP-9的变化及血必净对其影响。方法采用呼气末夹闭气管窒息法建立大鼠心脏骤停模型,并心肺复苏成功后生存24h,将50只健康Wistar大鼠随机分为5组,分别为模型组、正常对照组、小剂量血必净组、中剂量血必净组、大剂量血必净组。复苏24h后处死大鼠,取心、脑组织标本,电镜下观察心、脑组织的病理改变。采用酶联免疫吸附法(ELISA)检测心、脑组织中的ICAM-1和MMP-9含量变化。结果心、脑组织病理观察显示,与对照组相比其他组心脑细胞超微结构出现损伤性改变,其中模型组损伤最重,大剂量血必净组损伤性改变轻微;心、脑中ICAM-1和MMP-9含量变化,与对照组相比模型组心、脑ICAM-1和MMP-9含量明显升高,与模型组相比血必净治疗组心、脑ICAM-1和MMP-9含量明显下降;治疗组中,大、中剂量较小剂量下降更为明显。结论心跳骤停复苏后大鼠心、脑组织内ICAM-1和MMP-9等细胞因子含量增多,血必净可明显抑制心、脑组织中的细胞因子,而且存在明显量-效关系,从而缓解心跳骤停大鼠复苏中缺氧及再灌注后炎性因子所带来的损伤。

Objective To observe changes of intercellular adhesion molecule-1（ICAM-1） ,matrix metalloproteinase-9（MMP-9） and the effects of Xuebijing during cardiopulmonary cerebral resuscitation in rats.Methods The animal model of cardiac arrest（CA） was made by clamping endotracheal tube at expiration,and kept alive twent-four hours after cardiopulmonary resuscitation（CPR）.Fifty healthy Wistar rats were randomly divided into control group,model group,little dose of Xuebijing group,middle dose of Xuebijing group,high dose of Xuebijing group.The rats were killed after twenty-four hours.The cortex of the brain and the heart was taken out immediately to observe the ultrastructure changes.The levels of ICAM-1and MMP-9 were determined by ELISA.Results Compared with control group, the ultrstructure of brains and hearts was damadged in the other groups;compared with control group the level of ICAM-1and MMP-9 was increased significantly in the brains and hearts of model group,compare with model group, the level of ICAM-1 and MMP-9 reduced significantly in the brains and hearts of drug group.In the drug groups,compared with little dose group, the level of ICAM-1and MMP-9 reduced significantly in the high and middle dose group.Conclusion Quantitation of ICAM-1 and MMP-9 expression after cardiopulmonary cerebral resuscitation rats increases;Xuebijing significantly inhibits the increase of ICAM-1 and MMP-9 expression of cardiopulmonary cerebral resuscitation rats,with dose-dependent characteristies,and reduces the damage led by ischemia/reperfusion from cardiopulmonary cerebral resuscitation rats.