大鼠蛛网膜下腔出血致多器官功能障碍综合征延髓内脏带FOS蛋白的表达及迷走神经的作用研究

Fos protein expression in the medullary visceralzone and the effect of vagus nerve in rats following experimental subarachnoid hemorrhage complicated with MODS

目的观察大鼠蛛网膜下腔出血（SAH）致多器官功能障碍综合征（MODS）并/不并迷走神经切断时延髓内脏带（MVZ）FOS蛋白的表达规律,探讨MVZ和迷走神经在SAH致MODS中的可能调控机制。方法Willis环注血法建立SAH致MODS模型,膈下迷走神经切断法阻断迷走神经,免疫组织化学法检测MVZ内FOS蛋白的表达。结果（1）SAH组和SAH＋SDV组MVZ内FOS阳性表达明显高于正常对照组、假手术组、SDV组（P〈0.01）,但SAH＋SDV组明显少于SAH组（P〈0.01）,两组FOS蛋白表达均在24h达峰。（2）SAH组和SAH＋SDV组各时相点各脏器存在不同程度的炎性损害,以24～36h病理改变最显著,与FOS蛋白的表达峰值一致,而且SAH＋SDV组的炎性损害较SAH组更明显、持久。结论（1）SAH后各周围脏器的炎性改变与MVZ内FOS蛋白的表达规律相一致,提示MVZ参与了SAH后周围脏器功能的调控,是SAH致MODS的直接调控中枢之一;（2）膈下迷走神经切断增加了SAH后MODS的发生率,增强了SAH所致的周围脏器的炎性损害,提示迷走神经在SAH致MODS时对周围脏器具有潜在的保护作用。

Objective To investigate FOS protein expression in the medullary visceral zone（MVZ）of the rats following subarachnoid hemorrhage（SAH）complicated with multiple organ dysfunction syndrome（MODS） which complicated or uncomplicated by vagotomy,and to discuss the possible pathogenesis of MVZ and vagus nerve in the rats following SAH complicated with MODS.Methods SAH was induced in rats by injecting arterial blood through the circle of willis.The vagus never was blocked in rats from subdlaphragamatic vagotomy.The area density of positive staining expressing FOS protein were analyzed for the relative content of immunohistochemistry. Results （1）In the MVZ,the expression in FOS protein in SAH and SAH＋SDV groups were all obviously more than control group,sham-operative group and SDV group（ P 〈0.01）.But the expression in SAH＋SDV group were fewer and sparser than SAH group（ P 〈0.01）.FOS protein expressed in SAH and SAH＋SDV groups showed time progress and reached peak at 24h after SAH. （2）After SAH there are various inflammatory lesions on the organ tissue at every time point in SAH group and SAH＋SDV group.The organ has significantly pathological changes at 24~36h point which is at equal pace the regularity of the expression of FOS protein. But the inflammatory lesions in SAH＋SDV group was more serious and persistent than that in SAH group.Conclusions （1）There was the consistency between FOS protein expression and histological changes of each organ after SAH.It cued that MVZ may be one of the direct regulative centre after SAH by MODS. （2）Subdlaphragamatic vagotomy can add the incidences of MODS after SAH and can aggravate the imflamming lesions of peri-organs. Vagus never can protect peri-organs potatially when SAH complicated by MODS.