心肺复苏后吸入七氟醚通过调控Bcl-2/Bax减少神经元凋亡

doi:10.3969/j.issn.1002-1949.2018.04.017

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摘要目的观察大鼠心肺复苏（CPR）自主循环恢复（ROSC）后吸入七氟醚对大脑皮层神经细胞凋亡的影响。方法建立大鼠室颤后CPR模型(VF/CPR)。30只Wistar大鼠随机分为假手术组（Sham group）6只，七氟醚组（Sevo group）12只，对照组（Control group）12只。Sham组仅麻醉及气管插管，Sevo组在ROSC后立即吸入2.4%七氟醚10 min，Control组常规心肺复苏。ROSC 24 h后采用神经缺损评分（Neuro-Deficit Scoring, NDS）量表对大鼠神经功能进行评分；电镜观察线粒体损伤程度和TUNEL法对大脑皮层神经元细胞凋亡进行检测； Western blot检测Bcl-2、Bax和细胞色素C的蛋白表达水平，免疫组化检测活化的半胱氨酸蛋白酶（Cleaved-Caspase 3）的蛋白表达水平。结果实验前三组动物体质量、心率、平均动脉压差异无统计学意义，复苏中的CPR时间、除颤次数、肾上腺素使用剂量差异无统计学意义。ROSC 24 h后，Sevo组的NDS评分明显高于Control组。电镜下，Sevo组线粒体结构损害程度较轻；TUNEL法显示，凋亡细胞比例明显低于Control组［（12±6）% vs.（22±8）%，P＜0.01］。其次，Sevo组Bcl-2/Bax蛋白比值明显高于Control组［（54±11)% vs.（28±9）%，P＜0.01］，并可抑制细胞色素C的释放，减少Cleaved-Caspase 3的激活。结论 ROSC后吸入七氟醚，可减轻大脑皮层神经元凋亡，改善复苏后脑功能，其机制可能与调节Bcl-2/Bax表达有关。

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	卢远征
	李恒杰
	魏红艳
	杨焰
	黎博
	毛慧
	尹美娴
	胡春林
	廖晓星

关键词 ：心脏骤停, 室颤, 七氟醚, 复苏后脑损伤, Bcl-2/Bax, 凋亡

基金资助:国家自然科学基金(81571865)

通讯作者: 廖晓星(1955-)，男，博士生导师，主任医师，E-mail：liaowens@163.com。

作者简介: 卢远征（1983-），女，博士研究生，主治医师，E-mail：lyzicegril@163.com。

引用本文:

卢远征，李恒杰，魏红艳，杨焰，黎博，毛慧，尹美娴，胡春林，廖晓星. 心肺复苏后吸入七氟醚通过调控Bcl-2/Bax减少神经元凋亡[J]. 中国急救医学, 2018, 38(4): 357-.
Lu Yuan-zheng, Li Heng-jie, Wei Hong-yan, Yang Yan, Li Bo, Mao Hui, Yin Mei-xian, Hu Chun-lin, Liao xiao-xing. Sevoflurane inhalation attenuates the neuron apoptosis by modulation of Bcl-2/Bax expression after cardiac arrest in rats. Chinese Journal of Critical Care Medicine, 2018, 38(4): 357-.

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http://www.cnemergency.org.cn/CN/10.3969/j.issn.1002-1949.2018.04.017 或 http://www.cnemergency.org.cn/CN/Y2018/V38/I4/357

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