颅脑手术后苏醒期呛咳与S100B、细胞间黏附因子-1的表达

The expression of S100B, intercellular adhesion molecule-1 in craniotomy dogs associated reflex cough

目的 构建颅脑术后呛咳模型,探讨犬颅脑手术后苏醒期呛咳与脑损伤因子S100B、细胞间黏附因子-1（intercellular adhesion molecule-1,ICAM-1）的关系. 方法 按完全随机分组法将24只家犬分为实验组和对照组（每组12只）,24只家犬行颅脑手术,恢复自主呼吸时,实验组吸入辣椒素,对照组追加肌松药后再吸入辣椒素.辣椒素溶液定量雾化浓度为1 000 μmol/L,吸入时间为20 s.记录术前1 h（T0）、吸入雾化液时（T1）、吸入雾化液后1 min（T2）、吸入雾化液后5 min（T3）的平均动脉压（mean arterial blood pressure,MAP）和颅内压（intracranial pressure,ICP）改变.24 h后处死家犬,开颅取大小一致脑皮层组织,光镜观察脑出血情况,免疫组化S-P法检测S100B、ICAM-1在两组动物脑皮层组织中的表达情况. 结果 T2时实验组MAP[（153.1±8.1） mmHg（1 mmHg=0.133 kPa）]及ICP [（24.8±8.9） mmHg]与对照组MAP[（121.0±2.3） mmHg]及ICP[（12.6±1.2） mmHg]比较,差异有统计学意义（P＜0.01）.免疫组织化学显示S100B弱阳性（＋）中对照组7例、实验组0例,强阳性（＋＋＋）中对照组2例、实验组8例,ICAM-1阴性（-）中对照组6例、实验组1例,弱阳性（＋）中对照组4例、实验组5例,中度阳性（＋＋）中对照组2例、实验组4例,强阳性（＋＋＋）中对照组0例、实验组1例.S100B、ICAM-1在呛咳后实验组脑组织中过度表达,经Mann-Whitney U检验,实验组与对照组之间差异均有统计学意义. 结论 家犬雾化吸入辣椒素诱发呛咳反射可以作为研究呛咳反射的动物模型.S100B、ICAM-1在颅脑术后苏醒期呛咳表达增加.

Objective To investigate S100B,intercellular adhesion molecule-1 （ICAM-1） expression in craniotomy dogs associated reflex cough.Methods Twenty four dogs were given tracheal Intubation and craniotomy after general anesthesia.Dogs were randomly assigned to two groups：the experimental group （n=12） or normal group （n=12）.Capsaicin （1 000 μmol/L） was delivered via dosimeter and one-way （inspiratory） valve attached to a side port between the two groups tracheal tubes and pneumotachograph.Cisatracurium was injected to the normal group at the same time.Reflex cough response in experimental group is equal or greater than normal group times.Extubation of two group was done 1 h postoperatively.The changes on mean arterial pressure （MAP） and intracranial pressure （ICP） were observed 1 h （T0） preoperatively,after inhalation of atomized liquid （T1）,1 （T2）,5 min （T3） after inhalation of atomized liquid.All dogs were executed 24 h postoperatively.After that,the staining slices of brain tissues with the same size were made,and the levels of S100B,ICAM-1 in dog＇s brain were analyzed by immunohistochemical method.Results The MAP and ICP in experimental group were significantly higher than those in control group [（153.1 ±8.1）mmHg （1 mmHg=0.133 kPa） vs （121.0±2.3） mmHg,and （24.8±8.9） mmHg vs （12.6±1.2） mmHg]（P〈0.01）.S100B was weakly positive （＋） in the control group than in the experimental group （7 vs 0 cases）.Two cases showed strong positive （＋＋＋） in the control group while 8 cases were present in the experimental group.Six cases showed ICAM-1 negative（-） in the control group,while only one in experimental group showed ICAM-1 negative.Four cases were weakly positive （＋） in the control group,while 5 cases in experimental group.Two cases showed moderate positive （＋＋） in the control group,and 4 cases in the experimental group.For strong positive,0 case was in control group （＋＋＋）,while 1 case was in experimental group.The expression of S100B and ICAM-1 were significantly increased in the experimental groups.Mann-Whitney U analysis demonstrated that S100B and ICAM-1 expressions were associated with reflex cough.Conclusions The expressions on S100B,ICAM-1 are closely associated with reflex cough which may further exploded the blood vessel and injury the neurogliocyte cells.