论文部分内容阅读
目的:通过建立大鼠大脑中动脉闭塞模型,探讨肢体远端缺血后适应(limb remote ischemic postconditioning,RIP)对脑缺血再灌注损伤(ischemic/reperfusion,I/R)的影响。方法:将98只SD雄性大鼠随机分组,分为3大组:假手术组(n=14),对照组(缺血再灌注模型组,n=42),RIP组(缺血再灌注+肢体远端缺血后适应组,n=42),对照组和RIP组根据缺血再灌注之后不同时间再次分为12、24、72 h组,每组各14只。Longa评分法对其进行评分,HE染色、磁共振弥散加权像计算梗死体积百分比。测定缺血半暗带周围血管内皮生长因子(vascular endothelial growth factor,VEGF)、基质金属蛋白酶-9(matrix metalloproteinase-9,MMP-9)表达变化。结果:RIP组大鼠24 h后Longa评分较对照组有统计学意义(P=0.000)、RIP组大鼠HE染色脑梗死百分比在12、24、72 h均较对照组减少,差异有统计学意义(P=0.000)。免疫组织化学显示RIP组12、24、72 h在缺血半暗带周围VEGF表达均较对照组高,MMP-9表达均低于对照组,差异均有统计学意义(P=0.000)。结论:RIP减少缺血再灌注后24 h神经功能评分,减少梗死体积,具有减轻脑缺血再灌注损伤作用;远端缺血后适应明显增加缺血半暗带VEGF的表达,减少MMP-9的表达,表明RIP的神经保护作用与脑梗死后VEGF、MMP-9表达密切相关。
Objective: To investigate the effect of limb remote ischemic postconditioning (RIP) on cerebral ischemia-reperfusion (I / R) injury in rats by establishing middle cerebral artery occlusion model in rats. Methods: 98 SD male rats were randomly divided into three groups: sham operation group (n = 14), control group (ischemia / reperfusion model group, n = 42), RIP group Limb ischemic postconditioning group, n = 42). The control group and RIP group were divided into 12, 24 and 72 h groups according to different time after ischemia-reperfusion, 14 in each group. Longa scoring method to score them, HE staining, weighted diffusion weighted MRI infarction volume percentage. The changes of vascular endothelial growth factor (VEGF) and matrix metalloproteinase-9 (MMP-9) expression in the ischemic penumbra were measured. Results: The Longa score of rats in RIP group was significantly higher than that of control group after 24 hours (P = 0.000). The percentage of cerebral infarction in RIP group was lower than that of control group at 12, 24 and 72 hours Significance (P = 0.000). Immunohistochemistry showed that VEGF expression in RIP group at 12,24,72 h after ischemic penumbra was higher than that in control group, and MMP-9 expression was lower than that in control group (P = 0.000). CONCLUSION: RIP reduced the neurological deficit score 24 h after ischemia-reperfusion, reduced infarct volume and attenuated cerebral ischemia-reperfusion injury. Post-ischemic postconditioning significantly increased VEGF expression in ischemic penumbra and decreased MMP-9 The results showed that the neuroprotective effect of RIP was closely related to the expression of VEGF and MMP-9 after cerebral infarction.