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目的探讨小剂量甲基强的松龙(methylprednisolone,MP)与维生素C(vitamin C,Vc)联用对兔急性脊髓缺血再灌注损伤模型的保护作用。方法成年新西兰白兔144只,平均分为6组:阴性对照组(A组)、缺血再灌注组(B组)、小剂量MP组(C组)、Vc组(D组)、大剂量MP组(E组)、MP+Vc组(F组),每组24只。夹闭腹主动脉25 min后,移除动脉夹,造成缺血再灌注模型,随即给予相应的处理。于再灌注30 min、6、12、24、48 h每组各取4只动物,检测丙二醛(malondialdehyde,MDA)、过氧化氢酶(catalase,CAT)、超氧化物歧化酶(superoxide dismutase,SOD)、谷胱甘肽过氧物酶(glutathione peroxidase,GSH-Px)表达水平;每组取4只动物于麻醉清醒即刻,再灌注24、48 h按Tarlov评分系统行后肢运动功能评分,并于48 h评分完毕后取材行HE染色及TUNEL凋亡染色。结果A、E、F组MDA、CAT、SOD、GSH-Px于再灌注30 min、6、12、24 h表达水平明显低于B、C、D组(P<0.05),且A、E、F 3组间无明显差异(P>0.05);再灌注48 h Tarlov评分结果提示E(3.25±0.43)、F(3.50±0.50)组明显优于B(2.00±0.71)、C(2.50±0.50)、D(2.50±0.50)组;HE染色及TUNEL凋亡染色观察E组(29.68±4.57)%与F组(30.50±4.40)%损伤程度及细胞凋亡指数相当,均明显低于其他组。结论小剂量MP与Vc联合应用对急性脊髓缺血再灌注有明显的保护作用,且效果与大剂量MP相当,避免大剂量激素应用发生并发症的风险。
Objective To investigate the protective effect of low dose methylprednisolone (MP) combined with vitamin C (Vc) on acute spinal cord ischemia-reperfusion injury in rabbits. Methods A total of 144 adult New Zealand white rabbits were randomly divided into 6 groups: negative control group (group A), ischemia reperfusion group (group B), low dose MP group (group C), Vc group (group D) MP group (E group) and MP + Vc group (F group), 24 rats in each group. After clipping the abdominal aorta for 25 min, the artery clip was removed, resulting in a model of ischemia-reperfusion, followed by appropriate treatment. At 30 min, 6, 12, 24, and 48 h after reperfusion, 4 animals in each group were taken for detecting malondialdehyde (MDA), catalase (CAT), superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) were measured in each group. Four animals in each group were anesthetized immediately after awake, 24 h and 48 h after reperfusion. Tarlov scoring system was used to evaluate the hindlimb motor function, After 48 h, the samples were stained with HE staining and TUNEL staining. Results The expressions of MDA, CAT, SOD and GSH-Px in groups A, E and F at 30 min, 6, 12 and 24 h after reperfusion were significantly lower than those in groups B, C and D (P <0.05) (P> 0.05). Tarlov score at 48 h after reperfusion showed that E (3.25 ± 0.43) and F (3.50 ± 0.50) groups were significantly better than those of B (2.00 ± 0.71) and C ), And D (2.50 ± 0.50). HE staining and TUNEL staining showed that the degree of injury and apoptotic index in group E (29.68 ± 4.57)% and group F (30.50 ± 4.40)% were significantly lower than those in other groups . Conclusions The combination of low dose MP and Vc has a significant protective effect on acute spinal cord ischemia / reperfusion. The effect is equivalent to that of high dose MP, avoiding the risk of complications caused by high dose hormone.