丁苯酞对家兔心脏骤停复苏后炎症反应和脑损伤的作用

Effects of butylphthalide on inflammatory reaction and brain injuries in cardiac arrest rabbits after cardiopulmonary resuscitation

目的探讨丁苯酞(NBP)对家兔心脏骤停(CA)复苏后炎症反应和脑损伤的作用.方法56只家兔随机分为心脏骤停复苏对照组(CA组)、丁苯酞干预组(NBP组).两组均进行CA复苏建模.建模成功后CA组无干预观察至72 h,NBP组静脉注射丁苯酞[10 mL/(kg·d)]观察至72 h.两组分别于CA复苏前、自主循环恢复后12 h、24 h、72 h进行神经功能缺损评分(NDS)并处死3只,检测血清肿瘤坏死因子(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-1β(IL-1β)、血清神经元特异性烯醇化酶(NSE)、S-100B蛋白(S-100B)水平和脑组织含水量.结果NBP组自主循环恢复(ROSC)后TNF-α、IL-6、IL-1β各时间点的水平明显高于CA前(P<0.05),NDS评分均比CA组同时间点水平明显升高(分:65.61±3.51 vs.53.82±3.90,68.53±4.01 vs.56.81±3.81,75.33±2.24 vs.68.21±2.52,P<0.05).而NBP组ROSC后12h、24 h、72 h血清NSE水平均比CA组各同时间点明显降低(pg/mL:18.65±0.98 vs.22.01±2.21,21.68±1.52 vs.32.33±1.94,14.02±1.62 vs.19.67±1.88,P<0.05).同样NBP组ROSC后12 h、24 h、72 h血清S-100B水平均比CA组各同时间点明显降低(pg/mL:12.03±1.69 vs.17.11±3.68,8.63±2.13 vs.12.66±2.43,7.18±1.62 vs.8.24±1.86,P<0.05).而且NBP组72 h脑组织含水量明显低于同时间点CA组(P>0.05).结论丁苯酞能够改善家兔CA复苏后的炎症反应和脑损伤.

Objective To investigate the effects of butylphthalide after cardiopulmonary resuscitation in rabbits. Methods Fifty-six rabbits were randomly assigned to cardiac arrest (CA) group, and butylphthalide-treated group. Rabbits of CA and butylphthalide-treated group were made a model of cardiopulmonary resuscitation. The rabbits in CA group were observed until 72 h. The rabbits in butylphthalide-treated group received femoral vein injection of butylphthalide (10 mL per kilogram of body weight) immediately after the onset of cardiopulmonary resuscitation and then were observed until 72 h. The serum levels of tumor necrosis factor -α(TNF-α), interleukin-6(IL-6), interleukin-1β(IL-1β), neuron-specific enolase (NSE), neurotrophic protein S100B, and the content of water in brain were measured before CA and 12,24 and 72 hours after ROSC, respectively. Results The serum levels of TNF-α、IL-6, IL-β,were significantly lower in butylphthalide-treated group than those in CA group at 12、24 and 72 hours after ROSC. The scores of NDS were significantly higher in butylphthalide-treated group than those in CA group at 12, 24 and 72 hours after ROSC (65. 61 ±3. 51vs. 53. 82 ±3. 90, 68.53 ±4.01 vs. 56.81 ±3.81, 75.33 ±2.24 vs. 68.21 ±2.52, P<0.05). The serum level of NSE was significantly lower in butylphthalide-treated group than that in CA group at 12, 24 and 72 hours after ROSC (22.01 ±2.21 vs. 18.65 ±0.98, 32.33 ±1.94 vs. 21.68 ± 1.52, 19.67 ± 1.88 vs. 14. 02 ± 1. 62, P <0. 05). The serum level of S-100B was significantly lower in butylphthalide-treated group than that in CA group at 12, 24 and 72 hours after ROSC (12. 03 ± 1.69 vs. 17.11 ±3.68, 8.63 ±2.13 vs. 12.66 ±2.43, 7. 18 ±1.62 vs. 8.24 ±1.86, P<0.05). And the levels of the content of water in brain were significantly lower in butylphthalide-treated group than that in CA group at 72 hours after ROSC. Conclusion Butylphthalide treatment can inhibit inflammatory reaction and brain injury after cardiopulmonary resuscitation in rabbits.