摘要
目的探讨乌司他丁对大鼠心肺复苏（CPR）后脑含水含量、血清S100β蛋白及海马CA1区S100β蛋白表达变化的影响。方法成年雄性SD大鼠120只，随机分为假手术对照组（n=40）、复苏组（n=40）、乌司他丁组（n=40），每组按气管切开后（对照组）或自主循环恢复（ROSC）后（复苏组、乌司他丁组）0．5h，3h，6h，12h和24h分为5个亚组（n=8）。复苏组和乌司他丁组采用窒息致大鼠心脏骤停（CA）和心肺复苏（CPR）模型，乌司他丁组于ROSC后2min内经颈动脉推注注射用乌司他丁（10万U／kg）。对照组仅行麻醉、气管切开和血管穿刺。分别于各时间点取血和组织标本，以干湿比质量法测定脑组织含水量；ELISA法检测血清S100β蛋白质量浓度，免疫组化测定海马S100β蛋白的表达。数据处理应用SPSS10．0软件，多组比较采用方差分析。方差齐性检验采用用Levene’s法，方差齐性时采用LSD法，方差不齐时采用Tamhane’s检验，相关分析采用Person’s法。结果与对照组比较，复苏组ROSC后各亚组脑含水量显著升高（P〈0．05或P〈0．01），与复苏组比较，乌司他丁组12h，24h脑含水量显著降低（P〈0．05）。与对照组比较，复苏组血清S100β蛋白ROSC后0．5h起即明显升高，并持续上升至12h达峰值，24h有所回落，差异具有统计学意义（P〈0．01）；与复苏组比较，乌司他丁组ROSC后6h、12h、24h显著降低（P〈0．01）。免疫组化显示对照组海马CA1区S100β蛋白阳性细胞均维持在较低水平，复苏组ROSC后各时相海马CA1区S100β蛋白阳性细胞数均显著高于对照组（P〈0．05或P〈0．01）；与复苏组比较，乌司他丁组从ROSC后6h起S100β蛋白阳性细胞表达显著降低（P〈0．05）。且复苏后各时相海马CA1区S100β蛋白与脑含水量密切相关（r=0．862，P=0．015）。结论乌司他丁能降低大鼠心肺复苏后血清S100β蛋白、海马CA1区星形胶质细胞S100β蛋白表达和脑水肿程度，从而减轻脑损伤。
Objective To investigate the serum concentration and expressions of S100β protein in hippocampus CA1 region and the changes of water content in rats with asphyxia following ulinastatin injection after cardiopulmonary resuscitation （CPR）. Method One hundred twenty male adult SD rats were randomly divided into 3 groups： sham-operation group, CPR group and ulinastatin group. And each group was further divided into 5 subgroups （ n = 8） based on various intervals, 0.5 h,3 h,6 h, 12 h and 24 h after tracheotomy in sham-operation group or after ROSC in CPR group and tdinastatin group. Asphyxial cardiac arrest and CPR model of rat was used in CPR group and ulinastatin group in which bolus dose of 100 000 U/kg ulinastatin was injection into arteria carotis. Anaesthesia, tracheotomy and vascular cannulation without asphyxia and CPR in sham-operation group. Samples from subgroups were taken at different intervals. Brain water content was measured by using wet-dry weight method. Serum S100β protein was measured with enzyme-linked immunosorbent assay （ELISA）. The expression of S100β protein in hippocampus CA1 region was measured by using immunohistochemistry. Data were analyzed by SPSS version 10.0 software. Results Compared with sham-operation group, the brain water content of rats elevated significantly in all CPR subgroups after ROSC （ P 〈 0.05 or P 〈 0.01 ）. The brain water content of rats decreased significantly 12 h and 24 h after ROSC in ubnastatin group in comparison with CPR group （ P 〈 0.05） .The serum S100β protein started to elevated significantly 0.5 h after ROSC in CPR group, and reached the peak 12 h after ROSC （ P 〈 0.01 ）. Serum S100β decreased 6 h, 12 h and 24 h after ROSC in ulinastatin group compared with CPR group （ P 〈 0.01 ）. The expression of S100β protein in hippocampus CA1 region remained at a low level in sham-operation group. The expression of S100β protein elevated significantly in all CPR subgroups after ROSC compared with sham-operation group （ P 〈 0.05 or P 〈 0.01）. Compared with CPR group, the expression of S100β protein decreased after ROSC in ulinastafin group（ P 〈 0.05）. However, the expression of S100β protein in hippocampus CA1 region was significantly correlative with brain edema in all subgroups of CPR （ r = 0. 862, P 〈 0.05）. Conclusions Ulinastatin can decrease serum S100β protein and the expression of S100β protein in hippocampus CA1 region and lessen the severity of cerebral edema, alleviate the brain ischemic injury in rats after cardiopulmonary resuscitation.
出处
《中华急诊医学杂志》
CAS
CSCD
北大核心
2009年第2期170-174,共5页
Chinese Journal of Emergency Medicine
基金
温州市科技计划重点课题（Y2004A002）
浙江省卫生厅课题（2005B121）
温州医学院重大科研项目（yxyzd-B2004-18）
关键词
心肺复苏
S100Β蛋白
乌司他丁
脑损伤
海马CA1
自主循环恢复
Cardiopulrnonary resuscitation
S100β protein
Ulinastatin
Cerebral injury
Hippocampus CA1
Restoration of spontaneous circulation （ROSC）
