CAJ | 학술논문

　　目的探讨单纯疱疹病毒性脑炎（HSE）的发病机制以及阿昔洛韦和地塞米松的作用机制。方法雄性小鼠共102只，随机分为对照组、病毒感染组、阿昔洛韦组和联合用药组。采用颅内注射单纯疱疹病毒-1型建立HSE小鼠模型；颅内注射后第1天，阿昔洛韦组和联合用药组小鼠给予阿昔洛韦灌胃，对照组和病毒感染组给予生理盐水灌胃；颅内注射后第3天，联合用药组给予地塞米松腹腔注射，余组给予生理盐水腹腔注射。分别于模型建立后第3、6、9天行神经症状评分,并用免疫组化法测定小鼠脑组织中IL-2、IL-10的表达, HE染色比较脑组织病理变化。结果病毒感染组生存率最低，阿昔洛韦组次之，联合用药组最高（P<0.05）。第3、6、9天的神经症状评分均以病毒感染组最高，阿昔洛韦组次之，联合用药组最低（P<0.05）。小鼠脑组织病理和HE染色也显示同样的情况。第3、6、9天，小鼠脑内IL-2呈现先升高后下降的趋势，而IL-10呈逐渐上升趋势；在各时间点，各组小鼠间IL-2、IL-10表达差异均有统计学意义（P<0.05），其中均以病毒感染组高于阿昔洛韦组，阿昔洛韦组高于联合用药组（P均<0.05）；而联合用药组与对照组差异无统计学意义（P>0.05）。结论糖皮质激素联合抗病毒药物治疗HSE，较单纯阿昔洛韦治疗更能减少脑组织中IL-2、IL-10的分泌，减轻临床症状，提高生存率。
　　목적탐토단순포진병독성뇌염（HSE）적발병궤제이급아석락위화지새미송적작용궤제。방법웅성소서공102지，수궤분위대조조、병독감염조、아석락위조화연합용약조。채용로내주사단순포진병독-1형건립HSE소서모형；로내주사후제1천，아석락위조화연합용약조소서급여아석락위관위，대조조화병독감염조급여생리염수관위；로내주사후제3천，연합용약조급여지새미송복강주사，여조급여생리염수복강주사。분별우모형건립후제3、6、9천행신경증상평분,병용면역조화법측정소서뇌조직중IL-2、IL-10적표체, HE염색비교뇌조직병리변화。결과병독감염조생존솔최저，아석락위조차지，연합용약조최고（P<0.05）。제3、6、9천적신경증상평분균이병독감염조최고，아석락위조차지，연합용약조최저（P<0.05）。소서뇌조직병리화HE염색야현시동양적정황。제3、6、9천，소서뇌내IL-2정현선승고후하강적추세，이IL-10정축점상승추세；재각시간점，각조소서간IL-2、IL-10표체차이균유통계학의의（P<0.05），기중균이병독감염조고우아석락위조，아석락위조고우연합용약조（P균<0.05）；이연합용약조여대조조차이무통계학의의（P>0.05）。결론당피질격소연합항병독약물치료HSE，교단순아석락위치료경능감소뇌조직중IL-2、IL-10적분비，감경림상증상，제고생존솔。
Objectives To investigate the pathogenic mechanism of herpes simplex encephalitis (HSE) and the mecha-nism of action of dexamethasone and acyclovir. Methods 102 male mice were randomly assigned to normal control group, HSV-1 infection group, acyclovir-treated group and combination-treated group. The model of HSE was established by in-tracranial injection of HSV-1 in mice except normal controls. One day after intracranial injection, mice in acyclovir-treated group and combination-treated group were intragastrically administrated with acyclovir, and mice in normal control group and HSV-1 infection group were intragastrically administrated with normal saline. Three days after intracranial injection, mice in combination-treated group were intraperitoneally injected with dexamethasone and mice in other groups were in-traperitoneally injected with normal saline. The neurological injury score and the expressions of IL-2 and IL-10 of the mice brain tissues in each group were compared at 3, 6 and 9 days after model establishment. Results The survival rate of mice was lowest in HSV-1 infection group and highest in combination-treated group (P<0.05). The neurological injury scores at 3, 6 and 9 days were highest in HSV-1 infection group and lowest in the combination-treated group (P<0.05). The changes in brain tissue pathology and HE staining were closely corresponded to the neurological injury scores. At 3, 6 and 9 days, the expression of IL-2 was increased at first and then decreased, but the expression of IL-10 was gradually increased. The expressions of IL-2 and IL-10 were highest in HSV-1 infection group and lowest in combination-treated group. And differ-ences were significant among all groups at each time point (P<0.05) except between combination-treated group and normal control group (P>0.05). Conclusions In comparison with acyclovir monotherapy, combined treatment with dexamethasone and acyclovir for HSE can reduce the expression of IL-2 and IL-10, relieve the clinical symptoms, and increase the survival rate.