CAJ | 학술논문

目的研究腹部大手术后大鼠中枢单胺类神经递质含量的变化,探讨术后疲劳综合征中枢水平发生机制.方法将84只雄性成年SD大鼠随机分为疲劳评估组(包括模型组和假手术组)和实验组(分为术后1、3、5、7和14 d恢复组及各组对应的对照组).术后对大鼠进行疲劳评估,并在相应时间点取出大脑海马、中脑、下丘脑,检测脑组织5-羟色胺(5-HT)、去甲肾上腺素(NE)、多巴胺(DA)的含量及外周血游离色氨酸和支链氨基酸浓度.结果 3个脑区5-HT变化趋势类似,在术后3d内明显升高,术后第5天降至最低,至术后第14天逐渐恢复至平稳状态,实验组间比较及实验组与相应对照组比较,差异均有统计学意义(P＜0.05).海马和下丘脑NE和DA水平总体变化不明显,中脑NE和DA均在术后1d明显升高(P＜0.05).外周血中游离色氨酸和游离色氨酸/支链氨基酸比值在术后早期升高后,至第5天降至最低,后期游离色氨酸仍低于对照组水平,而游离色氨酸/支链氨基酸比值和支链氨基酸恢复至对照组水平,实验组间比较及实验组与相应对照组比较,差异均有统计学意义(P＜0.05).结论外周血中游离色氨酸和游离色氨酸/支链氨基酸比值及中枢5-HT水平的波动可能与腹部大手术后疲劳综合征的发生发展有着重要的联系.
목적 연구복부대수술후대서중추단알류신경체질함량적변화,탐토술후피로종합정중추수평발생궤제.방법 장84지웅성성년SD대서수궤분위피로평고조(포괄모형조화가수술조)화실험조(분위술후1、3、5、7화14 d회복조급각조대응적대조조).술후대대서진행피로평고,병재상응시간점취출대뇌해마、중뇌、하구뇌,검측뇌조직5-간색알(5-HT)、거갑신상선소(NE)、다파알(DA)적함량급외주혈유리색안산화지련안기산농도.결과 3개뇌구5-HT변화추세유사,재술후3d내명현승고,술후제5천강지최저,지술후제14천축점회복지평은상태,실험조간비교급실험조여상응대조조비교,차이균유통계학의의(P＜0.05).해마화하구뇌NE화DA수평총체변화불명현,중뇌NE화DA균재술후1d명현승고(P＜0.05).외주혈중유리색안산화유리색안산/지련안기산비치재술후조기승고후,지제5천강지최저,후기유리색안산잉저우대조조수평,이유리색안산/지련안기산비치화지련안기산회복지대조조수평,실험조간비교급실험조여상응대조조비교,차이균유통계학의의(P＜0.05).결론 외주혈중유리색안산화유리색안산/지련안기산비치급중추5-HT수평적파동가능여복부대수술후피로종합정적발생발전유착중요적련계.
Objective To explore the mechanism of postoperative fatigue syndrome (POFS) by detecting the change of central monoamine neurotransmitters in a rat model after major abdominal surgery.Method Eighty-four rats were randomly divided into fatigue assessment groups (including model group and sham group) and experimental groups (including postoperative day 1,3,5,7,and 14 recovery groups and the corresponding control groups).Postoperative fatigue was evaluated after surgery.The brains were removed thereafter to detect the levels of 5-hydroxytryptamine (5-HT),norepinephrine (NE),dopamine (DA) in the hippocampus,midbrain,hypothalamus by high performance liquid chromatography.Serum free tryptophan (f-Trp) and branched-chain amino acids (BCAA) were measured.Results The level of 5-HT increased to the highest at postoperative day 3,but reduced rapidly to the minimum at postoperative day 5,and then gradually recovered to the preoperative level.There was significant difference of 5-HT among experimental groups (P＜0.05),also between the postoperative 24 hrs group and control groups (P＜0.05).f-Trp and the ratio of f-Trp/BCAA increased in the early postoperative period,reduced to minimum at postoperative day 5.f-Trp was still lower compared to the control group at postoperative day 14,while the ratio of f-Trp/BCAA and BCAA restored to control level.Both of them were significantly different among experimental groups (P＜0.05),also between the experimental groups and control groups (P＜0.05).Conclusion Changes of f-Trp,the ratio of f-Trp/BCAA,and central 5-HT may play an important role in the development of POFS.