七氟醚后处理对大鼠窒息性心脏骤停心肺复苏后全脑损伤的保护作用

Neuroprotective effects of sevoflurane postconditioning on globalcerebral ischemic injury after cardiopulmonary resuscitation following asphyxial cardiac arrest in rats

目的评价不同浓度七氟醚后处理(SPC)对大鼠窒息性心脏骤停(CA)复苏后脑缺血损伤的保护作用。方法 80只健康雄性SD大鼠随机均分为五组:假手术组(S组)、模型组(C组)、0.5、1.0和1.5倍最低肺泡有效浓度(MAC)SPC组(P1、P2、P3组)。C、P1、P2和P3组建立8min窒息性CA模型,后给予心肺复苏抢救,并在复苏即刻给予间断吸入七氟醚2次,每次5min,间隔10min,确保浓度分别为1.25%、2.5%和3.75%。记录各组大鼠复苏后72h血糖值、血清神经元特异性烯醇化酶(NSE)含量、海马CA1区神经元形态学变化及海马区P53蛋白的表达,复苏后24、72h和7d的神经功能缺损评分(NDS评分),及复苏后7d至11d的大鼠空间学习记忆能力。结果P2、P3组复苏后血糖值、NSE值明显低于C组(P<0.05);S、P2、P3组海马CA1区存活神经元数量明显多于,p53蛋白表达明显少于C组(P<0.05);神经功能和空间学习记忆能力明显高于C组(P<0.05)。结论 1.0和1.5MAC浓度的SPC可以显著改善窒息性CA所致的大鼠全脑损伤。

Objective To evaluate the protection of different sevoflurane postconditioning（SPC）concentration on cerebral ischemic injury following asphyxial cardiac arrest（CA）in rats.Methods Eigty healthy male SD rats were randomly assigned to five groups：sham group（group S）;control group（group C）;0.5,1.0and 1.5MAC SPC group（groups P1,P2 and P3）.groups C,P1,P2 and P3were induced by 8-min asphyxiation and cardiopulmonary resuscitation.Sevoflurane were inhaled through the breathing machine respectively two times for 5min each at an interval of 10 min at the onset of resuscitation to achieve postconditioning,to conform its concentration 1.25%,2.5%and3.75% respectively in groups P1,P2 and P3.Record blood glucose,neuron specific enolase（NSE）,morphological change of neurons in hippocampus CA1 area,and expression of P53 in hippocampus area at 72 h,neurological deficit scores（NDS）at 24 h,72h,7dand spatial learning and memory ability from 7dto 11 dafter ROSC.Results Blood glucose and NSE levels in groups P2 and P3were lower than those of group C significantly（P〈0.05）.There were more neurons survival and less expression of apoptosis protein in hippocampus area,higher NDS,and better ability of spatial learning and memory in groups P2 and P3than those of group C（P〈0.05）.Conclusion Postconditioning with 1.0and1.5 MAC sevoflurane can significantly reduce global injury after CPR following asphyxial CA.