CAJ | 학술논문

目的研究不同程度亚低温对大鼠心肺复苏（CPR）后脑组织凋亡的影响。方法利用窒息法制作心肺复苏模型，SD大鼠15只，随机分为对照组（正常体温）、34℃低温组、32℃低温组，每组各5只。对照组在CPR后置于室温25℃下常规治疗；34℃低温组（34+/-0.2℃）和32℃低温组（32+/-0.2℃）在CPR 0.5 h后分别给予亚低温治疗。各组大鼠均于CPR后12 h取脑组织，免疫组化法测定大脑皮层caspase-3蛋白表达，Western blotting测定Bcl-2、Bax表达，同时观察各组脑组织病理变化。结果与常温组相比，低温组神经元caspase-3表达均明显减弱（P<0.05），其中32℃低温组caspase-3表达减弱更加明显（P<0.05）；低温组Bcl-2表达明显增强（P<0.05），32℃低温组的Bcl-2蛋白表达比34℃低温组表达更强；3组大鼠神经元凋亡蛋白bax的表达无明显差异。结论亚低温可能通过降低caspase-3蛋白的表达、增强Bcl-2的表达，从而抑制脑细胞凋亡减轻脑损伤，32℃亚低温治疗比34℃更能起到脑保护的作用。
목적연구불동정도아저온대대서심폐복소（CPR）후뇌조직조망적영향。방법이용질식법제작심폐복소모형，SD대서15지，수궤분위대조조（정상체온）、34℃저온조、32℃저온조，매조각5지。대조조재CPR후치우실온25℃하상규치료；34℃저온조（34+/-0.2℃）화32℃저온조（32+/-0.2℃）재CPR 0.5 h후분별급여아저온치료。각조대서균우CPR후12 h취뇌조직，면역조화법측정대뇌피층caspase-3단백표체，Western blotting측정Bcl-2、Bax표체，동시관찰각조뇌조직병리변화。결과여상온조상비，저온조신경원caspase-3표체균명현감약（P<0.05），기중32℃저온조caspase-3표체감약경가명현（P<0.05）；저온조Bcl-2표체명현증강（P<0.05），32℃저온조적Bcl-2단백표체비34℃저온조표체경강；3조대서신경원조망단백bax적표체무명현차이。결론아저온가능통과강저caspase-3단백적표체、증강Bcl-2적표체，종이억제뇌세포조망감경뇌손상，32℃아저온치료비34℃경능기도뇌보호적작용。
Objective To explore the effect of mild to moderate hypothermia on the expressions of apoptosis-related genes in the brain tissue of rats after cardiopulmonary resuscitation (CPR). Methods CPR models were established by asphyxia in 15 male SD rats, which were randomized equally into normal temperature group, 34 ℃ hypothermia group and 32 ℃ hypothermia group. The brain tissues of the rats were obtained after treatment for 12 h to observe the pathological changes. The expression of caspase-3 in cerebral cortex neurons was determined with immunohistochemistry, and the expressions of Bcl-2 and Bax were detected by Western blotting. Results Compared with normal temperature group, the two hypothermia groups (especially 32℃group) showed significantly decreased expression of caspase-3 in the cortical neurons (P<0.05). Bcl-2 protein expression was significantly increased in the hypothermia groups, especially in 32℃hypothermia group (P<0.05). There was no significant difference in Bax protein expression among the 3 groups. Conclusion Mild hypothermia can relieve brain injury by down-regulating caspase-3 expression and up-regulating Bcl-2 protein expression to inhibit apoptosis of the brain neurons. Hypothermia at 32℃offers better protection of the brain tissue than hypothermia at 34℃.