心肺复苏后大鼠神经细胞损伤的机理研究

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目的:采用窒息合并冰氯化钾停跳液致大鼠心跳骤停-心肺复苏模型,研究全脑缺血再灌注后神经细胞损伤的可能机制。方法:本实验采用窒息合并冰氯化钾停跳液致大鼠心跳骤停,5分钟后开始心肺复苏。Sprague Dawley大鼠28只,雌雄各半,随机分5组:对照组(假手术组)、复苏后3小时组、复苏后6小时组、复苏后12小时组、复苏后24小时组;对照组4只,其余每组6只。采用酶生化法测定复苏后3、6、12和24小时血浆中CK-BB的含量;采用放射免疫法测定复苏后3、6、12和24小时血浆中TNF-α和IL-1β的含量;并对复苏后6、12和24小时神经功能评分。采用TUNEL方法和透射电镜观察复苏后神经细胞的凋亡情况;采用免疫组化的方法观察复苏后3、6、12和24小时脑组织中bcl-2、bax、bak和NF-κB的表达情况。结果:复苏后3小时CK-BB就明显升高,6小时为高峰;复苏后3、6、12和24小时血浆中TNF-α和IL-1β的含量无明显变化。假手术组无细胞凋亡现象发生,复苏后3小时大鼠脑皮质神经元就出现细胞凋亡,复苏后24小时海马区TUNEL阳性率为6.0%;复苏后bcl-2在海马区的表达不断上升,但明显较bax表达为弱,bcl-2/bax比例失衡;复苏后6小时开始有NF-κB表达,到24小时达11.2%。结论:细胞凋亡可能是大鼠全脑缺血再灌注后神经细胞损伤的主要机制之一,其中bcl-2/bax比例失衡和NF-κB的激活可能是导致细胞凋亡的主要原因之一
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