七氟烷预处理对1型糖尿病大鼠术后认知功能的影响

Effect of sevoflurane preconditioning on postoperative cognitive function in type 1 diabetic rats

目的探讨七氟烷预处理对1型糖尿病大鼠术后认知功能的影响。方法取无特定病原体级SD雄性大鼠120只，根据随机数字表法，将大鼠分为对照组、手术组、七氟烷预处理组和正常组，各30只。前3组进行1型糖尿病大鼠造模成功，最后一组不进行造模。造模后，对照组仅给予戊巴比妥钠麻醉，不进行手术；手术组给予戊巴比妥钠麻醉后行剖腹探查术，手术时间30min；七氟烷预处理组给予吸入2．4％七氟烷30min，然后吸入空气30main，后续处理同手术组；正常组同七氟醚预处理组。统计并比较4组术前30min及术后1、3、7dMorris水迷宫实验逃避潜伏期和穿越原平台次数和应用酶联免疫吸附法测定4组术前30min及术后1、7d肿瘤坏死因子α（TNF—α）和白细胞介素1β（IL-1β）水平。结果七氟烷预处理组术前30min和术后1、3、7d逃避潜伏期长于正常组[（24．0±2．2）s比（20．2±1．8）s、（42．6±5．6）s比（32．5±3．0）s、（32．6±4．2）s比（26．2±2．6）s、（26．5±2．8）S比（24．8±2．0）s]，术后1、3、7d实验逃避潜伏期长于对照组[（24．0±2．4）、（23．6±2．2）、（24．4±2．3）s]、短于手术组[（70．6±5．8）、（46．8±5．1）、（34．5±3．6）s]；术后1、3d穿越原平台次数少于正常组[（6．8±3．0）次比（14．2±3．6）次、（10．2±2．5）次比（13．5±3．0）次]、对照组[（13．0±3．2）、（14．2±4．0）次]，术前30min和术后1、3、7d穿越原平台次数多于手术组[（14．0±2．8）次比（12．6±3．3）次、（6．8±3．0）次比（4．2±1．5）次、（10．2±2．5）次比（6．5±2．0）次、（15．2±3．5）次比（9．5±2．5）次]，差异有统计学意义（P〈0．05）。七氟烷预处理组术前30min和术后1、7dTNF-α和IL-1β水平均低于正常组、对照组和手术组，差异有统计学意义（P〈0．05）。结论七氟烷预处理可降低1型糖尿病大鼠术后认知功能障碍发生率。

Objective To investigate the effect of sevoflurane preconditioning on postoperative cognitive function in type 1 diabetic rats. Methods A total of 120 male SD rats were randomly divided into control group, operation group, sevoflurane preconditioning group and normal group, with 30 rats in each group. Rats in control group, operation group and sevofgurane preconditioning group were induced type 1 diabetes. The control group had sodium pentobarbital anesthesia without surgery. The operation group had exploratory laparotomy under sodium pentobarbital anesthesia and the operation lasted for 30 min. The sevoflurane preconditioning group and the normal group inhaled 2.4% sevoflurane 30 rain and pure air 30 min before operation. Morris water maze escape latency and the number of times of crossing original platform were tested 30 min before and 1, 3, 7 d after operation. Levels of tumor necrosis factor-α（TNF-α） and interleukin-1β（IL-1β） were tested 30 min before and 1,7 d after operation. Results Escape latencies in sevoflurane preconditioning group were significantly longer than those in normal group at 30 min before and 1,3, 7 d after operation [ （24.0 ± 2. 2） s vs （ 20. 2 ± 1.8 ） s, （42. 6 ± 5.6） s vs （32. 5 ± 3.0） si （32. 6 ± 4. 2） s vs （26.2 ± 2. 6） s, （26. 5 ± 2. 8） s vs （24. 8 ± 2. 0） s ] ; escape latencies 1, 3, 7 d after operation in sevoflurane preconditioning group were significantly longer than those in control group [ （24. 0 ± 2. 4） s, （23.6 ± 2. 2） s, （24.4 ± 2. 3 ） s ] and shorter than those in operation group [ （70. 6 ± 5.8 ） s, （46. 8 ± 5. 1 ） s, （34. 5 ± 3.6） s ] （ P 〈 0. 05 ）. Times of crossing original platform in sevoflarane preconditioning group were significantly less than those in normal group and control group at 1, 3 d after operation [ （6. 8 ± 3.0） times vs （ 14. 2 ± 3.6） times, （ 13.0 ± 3.2 ） times ; （ 10. 2 ± 2. 5 ） times vs （ 13.5 ± 3.0 ） times, （ 14. 2 ±. 4. 0）times]; times of crossing original platform 30 rain before and 1, 3, 7 d after operation in sevofiurane preconditioning group were significantly more than those in operation group [ （ 14. 0 ± 2. 8 ） times vs （ 12. 6 ± 3.3）times, （6.8 ± 3.0） times vs （4.2 ± 1.5） times, （10.2 ±2.5）times vs （6.5 ± 2.0） times, （15.2 ± 3.5）timesvs （9.5 ±2.5）times] （P〈0.05）. Levels of TNF-ct and IL-113 30 min before and 1, 7 d after operation in sevoflurane preconditioning group were significantly lower than those in normal group, control group and operation group （P 〈 0. 05 ）. Conclusion Sevoflurane preconditioning can reduce the int：idence of postoperative cognitive dysfunction in type 1 diabetic rats.