MIS后病灶区灌注RSG对家兔ICH模型血肿周围继发性脑损伤的作用

Effects of rosiglitazone infusion therapy following minimal invasive surgery for intracerebral hemorrhage evacuation on perihematomal secondary brain injury in rabbits

目的探讨立体定向微创颅内血肿清除术(MIS)后病灶区灌注罗格列酮(RSG)对家兔脑出血(ICH)模型血肿周围继发性脑损伤的作用。方法 60只家兔分为4组,分别为模型对照组(MC组)、罗格列酮组(RSG组)、微创手术组(MIS组)和微创手术+罗格列酮组(MIS+RSG组)。各组家兔均制作ICH模型,MC组及RSG组在模型制作成功后6h模拟手术过程进行假性血肿清除,RSG组病灶区灌注RSG,MIS组及MIS+RSG组进行微创血肿清除,MIS+RSG组随后病灶区灌注RSG,于实施相关处理后第7天对各组家兔进行神经功能缺损(Purdy)评分并处死,取血肿周围脑组织检测过氧化物酶体增殖物激或受体γ(PPARγ)水平及血脑屏障(BBB)通透性。结果 MC组Purdy评分、BBB通透性明显高于其他组,提示颅内血肿损害神经功能并破坏BBB通透性;与MC组相比,RSG组及MIS+RSG组的PPARγ表达显著增加,而MIS组PPARγ表达减少,提示RSG能明显增加PPARγ的表达,而微创清除颅内血肿后则可减少PPARγ的产生;与MC组比较,RSG组及MIS组血肿周围伊文思蓝(EB)水平显著降低,提示RSG治疗及MIS均可降低BBB通透性,MIS+RSG组EB含量降低更为明显,提示MIS后病灶区灌注RSG降低BBB通透性的效果更加明显。结论 MIS后病灶区灌注PPARγ激动剂RSG能有效减少家兔ICH模型继发性脑组织损伤,改善神经功能。

Objective To observe the effects of rosiglitazone（RSG）infusion therapy following minimal invasive surgery （MIS）for intracerebral hemorrhage（ICH）evacuation on perihematomal secondary brain injury in rabbits. Methods A total of 60 rabbits were randomly assigned to a model control group（MC group）, a RSG medication group（RSG group）, a minimally invasive surgery group（MIS group）and a MIS combined with RSG group（MIS＋RSG group）. An ICH was induced in all rabbits. The MC group and the RSG group just received a sham minimally invasive procedures at 6 h after the ICH model was prepared successfully. The RSG group perfused RSG to the perihematomal brain tissues. A MIS was performed in the MI$ group and the MIS＋ RSG group. RSG infusion therapy following MIS in the MIS＋RSG group. All rabbits were killed on the 7th d after the relative processes were performed successfully. Neurological deficit scores were determined,and the perihematomal brain tissues were obtained to determine the PPAR7 and the blood-brain barrier（BBB） permeability. Results The neurological ：deficit scores,the BBB permeability were increased in the MC group when compared to the other groups,these results showed that the ICH disrupted BBB and damaged neurological function. The PPARy were all Significantly increased in the RSG group and the MIS＋RSG group, but decreased in the MIS group compared with the MC group, these results showed that RSG could increased in the expression of the PPARy levels but decreased after MIS for ICH. The Evan＇s Blue（EB）were decreased in the RSG group and the MIS group compared with the MC group which means RSG medication and the MIS could decreased the BBB permeability. The MIS＋RSG group had a remarkable results. The MIS＋RSG group displayed a great decrease in BBB permeability. Conclusion Performing the MIS followed by PPARy agonist RSG might be more efficacious for reducing secondary brain injury and improving the neurological function for ICH model in rabbits.