体外循环对大鼠术后认知功能障碍影响

Effect of cardiopulmonary bypass on postoperative cognitive dysfunction in rats

目的探讨体外循环(CPB)对大鼠术后认知功能障碍(POCD)的影响。方法将24只成年雄性SD大鼠随机分为S组(n=12)和C组(n=12)。观察两组海马组织细胞凋亡形态;检测血清中炎性因子白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α),脑损伤标志物S-100β以及caspase-3蛋白表达的变化情况。结果 C组在CPB转流前(T_0)、CPB术后1 d(T_1)、CPB术后3 d(T_3)、CPB术后7 d(T_7)的IA值均高于S组,组间比较,差异均有统计学意义(P <0. 05);与T_0时比较,C组大鼠海马阳性细胞IA值在T_1、T_3时间点均显著升高(P <0. 05)。C组T_1、T_3时间点caspase-3表达明显高于S组,组间比较,差异有统计学意义(P <0. 05); C组T_1、T_3时caspase-3表达明显高于T_0、T_7时(P <0. 05)。C组T1、T3时S100-β、IL-6、TNF-α浓度均明显高于T_0、T_7时,差异有统计学意义(P <0. 05)。T_1、T_3时,C组血清S100-β、IL-6和TNF-α浓度均高于S组,差异有统计学意义(P <0. 05)。结论结论 CPB可引起炎症相关的大鼠海马损伤并导致POCD的发生,且术后第1天最严重。

Objective To investigate the effect of cardiopulmonary bypass on postoperative cognitive dysfunction in rats.Methods Twenty-four adult male SD rats were randomly divided into the S group(n=12)and the C group(n=12).The apoptosis morphology of hippocampal cells was observed.Serum levels of inflammatory cytokines interleukin-6(IL-6),tumor necrosis factor-alpha(TNF-α),S-100βmarkers of brain injury and expression changes of caspase-3 protein were measured.Results IA values of C group before CPB shunt(T0),1 day after CPB surgery(T1),3 days after CPB surgery(T3),and 7 days after CPB surgery(T7)were all higher than those of S group(P<0.05).Compared with T 0,IA value of hippocampal positive cells in C group was significantly increased at T1 and T3 time points(P<0.05).Caspase-3 expression at T1 and T3 time points in C group was significantly higher than that in S group(P<0.05).Caspase-3 expression in C group at T1 and T3 was significantly higher than that at T0 and T7(P<0.05).The concentration of S100-β,IL-6 and TNF-αin C group at T1 and T3 was significantly higher than that at T0 and T7(P<0.05).At T1 and T3,serum concentrations of S100-β,IL-6 and TNF-αin C group were higher than those in S group(P<0.05).Conclusion Cardiopulmonary bypass can cause inflammation-related hippocampal injury and POCD in rats,the most serious situations will occur at the first postoperative day.