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背景:炎性细胞因子的释放、粘附分子上调导致的白细胞浸润与脑梗死灶的形成有密切关系,哪些因素对其能产生影响已得到人们的广泛关注。目的:探讨雌激素对大鼠局灶性脑缺血再灌注损伤后炎症反应的影响。设计:随机对照实验。单位:解放军南京军区南京总医院。材料:实验在解放军南京军区南京总医院神经内科和病理科完成。成年雌性SD大鼠,制作脑缺血模型时体质量控制在280～350g。方法:大鼠分3组:对照组、卵巢切除组、雌激素治疗组(雌二醇,200μg/kg,皮下注射,每周1次,共4周)。4周后线栓法建立右侧大脑中动脉闭塞1h、2h再灌注0、1、3、6、22、70h模型。在苏木精-伊红染色缺血半球选取10个高倍视野计算脑组织内浸润的中性粒细胞均数,免疫组化检测核因子κB表达。主要观察指标:脑实质内中性粒细胞浸润程度和核因子κB表达水平。结果:①核因子-κB表达:卵巢切除组缺血1h即有表达,对照组及雌激素治疗组在缺血2h才有阳性细胞,3组均在缺血2h再灌注3h时相表达最强,后逐渐降低,卵巢切除组在再灌注70h仍有少量表达,对照组及雌激素治疗组再灌注22h后未见核因子κB阳性细胞。②在缺血2h再灌注22h时,卵巢切除组动物脑缺血区中性粒细胞浸润数量明显增多,与雌激素治疗组相比,差异有显著性差异(P=0.045)熏在缺血2h再灌注70h时,卵巢切除组仍多于对照组和雌激素治疗组,但仅和对照组的差异有显著性意义。结论:雌激素能抑制脑缺血再灌注损伤后炎症反应。
BACKGROUND: The release of inflammatory cytokines, the leukocyte infiltration caused by the up-regulation of adhesion molecules and the formation of cerebral infarction are closely related to each other. Objective: To investigate the effect of estrogen on the inflammatory response after focal cerebral ischemia-reperfusion injury in rats. Design: Randomized controlled experiment. Unit: Nanjing Military Region People’s Liberation Army Nanjing General Hospital. MATERIALS: Experiments were performed in the Department of Neurology and Pathology, Nanjing General Hospital of the PLA Nanjing Military Region. Adult female Sprague-Dawley rats, making cerebral ischemia model body weight control in 280 ~ 350g. Methods: Rats were divided into 3 groups: control group, ovariectomized group, estrogen treatment group (estradiol, 200μg / kg, subcutaneously once a week for 4 weeks). After 4 weeks, the right middle cerebral artery was occluded for 1h and reperfusion for 0h, 1h, 3h, 6h, 2h, 70h and 2h respectively. Ten hematoxylin and eosin staining hemispheres were selected to calculate the number of infiltrated neutrophils in brain tissue and the expression of nuclear factor kappa B was detected by immunohistochemistry. MAIN OUTCOME MEASURES: Neutrophil infiltration and nuclear factor κB expression in brain parenchyma. Results: ① The expression of NF-κB was detected in the ovariectomized group 1 h after ischemia, while the control group and the estrogen-treated group had positive cells only 2 h after ischemia. The expression of NF-κB was the highest at 3 h after ischemia in 2 h , And then gradually decreased. Ovarian resection group still showed a small amount of expression at 70h after reperfusion, and there was no nuclear factor κB positive cells in control group and estrogen treatment group after reperfusion for 22h. ② At 22h after reperfusion for 2h, the number of neutrophil infiltration in the ovariectomized group was significantly increased compared with the estrogen-treated group (P = 0.045) At 70h after reperfusion, the ovariectomized group was still more than the control group and the estrogen treatment group, but only with the control group differences were significant. Conclusion: Estrogen can inhibit the inflammatory reaction after cerebral ischemia-reperfusion injury.