CAJ | 학술논문

目的 ①探讨脑出血(CH)致多器官功能障碍综合征(MODS)大鼠模型下丘脑、延髓内脏带(MVZ)及迷走神经的作用;②揭示脑源性多器官功能障碍综合征(CMODS)时下丘脑、延髓内脏带及迷走神经的可能调控机制.方法 Wistar大鼠80只用随机数字表法分为:假手术组(10只)、迷走神经切断(SDV)组(10只)、CH组(20只)、脑出血+迷走神经切断(CH+SDV)组(20只)、脑出血+迷走神经刺激(CH+SIV)组(20只).尾状核胶原酶注入法制作大鼠CH模型,偶氮显色鲎试验法定量测定血清内毒素,免疫组织化学法检测下丘脑FOS蛋白及延髓内脏带(MVZ)内乙酰胆碱转移酶(CHAT)的表达.结果 CH+SDV组、CH+SIV组和CH组的肝、肾功能,心肌酶异常程度均重于假手术组和SDV组,CH+SDV组重于CH组,而CH+SIV组明显轻于CH组;CH组血清内毒素含量(EU/m1)与假手术组比较差异有统计学意义(1.03±O.25与0.18±0.03,t=10.61,P<0.01);CH+SDV组下丘脑内FOS蛋白的表达(9.3±2.6)明显多于假手术组(2.5±0.4,t=8.17,P<0.01)和SDV组(2.9±0.5,t=7.64,P<0.01),但明显少于CH组(48.6±18.1,t=6.80,P<0.01),CH+SIV组明显多于CH组(74.3±6.3与48.6±18.1,t=4.23,P<0.01);CH+SDV组的MVZ内CHAT的表达(138.5±11.8)明显多于假手术组(108.2±9.5,t=5.39,P<0.01)和SDV组(110.7±9.9,t=4.83,P<0.01),但明显少于CH组(164.4±12.4,t=3.53,P<0.01),CH+SIV组明显多于CH组(189.4±15.0与164.4±12.4,t=3.14,P<0.05).结论 ①下丘脑与CH致MODS的神经免疫调节有关;②下丘脑-延髓内脏带-迷走神经通路机制可能是CMODS的特性;③迷走神经可能是CH致MODS的双向调节通路.
목적 ①탐토뇌출혈(CH)치다기관공능장애종합정(MODS)대서모형하구뇌、연수내장대(MVZ)급미주신경적작용;②게시뇌원성다기관공능장애종합정(CMODS)시하구뇌、연수내장대급미주신경적가능조공궤제.방법 Wistar대서80지용수궤수자표법분위:가수술조(10지)、미주신경절단(SDV)조(10지)、CH조(20지)、뇌출혈+미주신경절단(CH+SDV)조(20지)、뇌출혈+미주신경자격(CH+SIV)조(20지).미상핵효원매주입법제작대서CH모형,우담현색후시험법정량측정혈청내독소,면역조직화학법검측하구뇌FOS단백급연수내장대(MVZ)내을선담감전이매(CHAT)적표체.결과 CH+SDV조、CH+SIV조화CH조적간、신공능,심기매이상정도균중우가수술조화SDV조,CH+SDV조중우CH조,이CH+SIV조명현경우CH조;CH조혈청내독소함량(EU/m1)여가수술조비교차이유통계학의의(1.03±O.25여0.18±0.03,t=10.61,P<0.01);CH+SDV조하구뇌내FOS단백적표체(9.3±2.6)명현다우가수술조(2.5±0.4,t=8.17,P<0.01)화SDV조(2.9±0.5,t=7.64,P<0.01),단명현소우CH조(48.6±18.1,t=6.80,P<0.01),CH+SIV조명현다우CH조(74.3±6.3여48.6±18.1,t=4.23,P<0.01);CH+SDV조적MVZ내CHAT적표체(138.5±11.8)명현다우가수술조(108.2±9.5,t=5.39,P<0.01)화SDV조(110.7±9.9,t=4.83,P<0.01),단명현소우CH조(164.4±12.4,t=3.53,P<0.01),CH+SIV조명현다우CH조(189.4±15.0여164.4±12.4,t=3.14,P<0.05).결론 ①하구뇌여CH치MODS적신경면역조절유관;②하구뇌-연수내장대-미주신경통로궤제가능시CMODS적특성;③미주신경가능시CH치MODS적쌍향조절통로.
Objective To investigate the role of the hypothalamus, medullary visceral zone (MVZ)and vagus in cerebral hemorrhage (CH) in multiple organ dysfunction syndrome (MODS) rat model.To reveal the possible regulatory mechanism of the hypothalamus-MVZ-vagus pathway in CMODS.Methods 80 Wistar rats were randomly divided into sham-operative group (n = 10), subdiaphragmatic vagotomy group (SDV, n = 10), CH group (n = 20), CH + SDV group (n = 20) and CH + vagus stimulation group (CH +SIV, n = 20).Rat CH model was made by stereotaxis injection of collagenase in caudate nucleus.Its endotoxin in serum was evaluated with a test kit.The expression of FOS in the hypothalamus and CHAT in the MVZ in the rats were examined using immunohistochemistry methods.Results Abnormality of hepatic and renal function, myocardium enzyme in CH + SDV group, CH + SIV group and CH group were more severe than those in sham-operative group and SDV group; CH + SDV group more severe than CH group.CH +SIV group were much milder than CH group.The serum endotoxin level (EU/ml) in CH group,compared with the sham-operated group, were significantly different (1.03 ± 0.25 and 0.18 ± 0.03respectively, t = 10.61, P <0.01).The expression of FOS in hypothalamus of CH + SDV group (9.3 ±2.6) were significantly higher than those in sham-operative group (2.5 ± 0.4, t = 8.17, P < 0.01) and SDV group (2.9 ±0.5, t =7.64, P <0.01), but significantly lower than those in CH group (48.6 ± 18.1,t =6.80, P<0.01); was higher in CH +SIV group than those in CH group (74.3 ±6.3 and 48.6 ± 18.1,t=4.23, P <0.01).The expression of CHAT in MVZ in CH + SDV group (138.5 ± 11.8) was significantly higher than those in sham-operative group (108.2 ±9.5, t =5.39, P <0.01) and SDV group (110.7 ±9.9, t =4.83, P <0.01), but significantly lower than those in CH group (164.4 ± 12.4, t =3.53, P <0.01); was higher in CH + SIV group than in CH group (189.4 ± 15.0 and 164.4 ± 12.4, t =3.14, P < 0.05).Conclusion Hypothalamus may be related to the nerve immunity adjustment in MODS after cerebral hemorrhage.The hypothalamus-MVZ-vagus pathway may be distinctive in CMODS.Vagus nerve may be a Bi-directional Channel of the rats following cerebral hemorrhage and MODS.