中华急诊医学杂志
中華急診醫學雜誌
중화급진의학잡지
CHINESE JOURNAL OF EMERGENCY MEDICINE
2013年
5期
496-500
,共5页
王晓萍%赵燊%林庆明%陈敏%陈锋
王曉萍%趙燊%林慶明%陳敏%陳鋒
왕효평%조신%림경명%진민%진봉
脑出血%脑水肿%低温%缺氧诱导因子-1α%血管内皮生长因子
腦齣血%腦水腫%低溫%缺氧誘導因子-1α%血管內皮生長因子
뇌출혈%뇌수종%저온%결양유도인자-1α%혈관내피생장인자
Cerebral hemorrhage%Cerebral edema%Hypothermia%Hypoxia-inducible factor 1 α%Vascular endothelial growth factor
目的 观察不同时程治疗性亚低温对大鼠脑出血(ICH)后脑水肿及对缺氧诱导因子-1α (HIF-1α)、血管内皮生长因子(VEGF)表达的影响,探讨亚低温减轻ICH后脑水肿的可能的机制及方法.方法 采用自体股动脉血注入右侧基底节区制作ICH模型,将40只雄性SD大鼠,随机(随机数字法)分为5组(各8只):假手术组(sham)、常温出血组(NT)、亚低温1h组(MH1)、亚低温2h组(MH2)、亚低温4h组(MH3).NT组、Sham组体温控制(37.0±0.2)℃；亚低温组ICH后即刻快速降至(33.0±0.5)℃并分别持续1、2、4h.在脑出血后48 h,各组分别进行脑含水量、血脑屏障通透性检测,应用Real-time PCR及Western blot检测HIF-1α、VEGF mRNA及蛋白.结果 NT组脑含水量、伊文氏蓝含量、HIF-1α、VEGF mRNA及蛋白表达明显高于sham组(P＜0.01)；MH1组与NT组比,HIF-1α mRNA及蛋白表达减少(P＜0.05)；MH2组、MH3组与NT组比,上述指标均下调；MH2组与MH3组结果差异无统计学意义.结论 ICH后早期快速的治疗性亚低温可能在转录水平下调HIF-1 α mRNA及蛋白表达,进而抑制VEGF mRNA及蛋白,减轻ICH后脑水肿.低温2h与4h对脑水肿的改善相同.
目的 觀察不同時程治療性亞低溫對大鼠腦齣血(ICH)後腦水腫及對缺氧誘導因子-1α (HIF-1α)、血管內皮生長因子(VEGF)錶達的影響,探討亞低溫減輕ICH後腦水腫的可能的機製及方法.方法 採用自體股動脈血註入右側基底節區製作ICH模型,將40隻雄性SD大鼠,隨機(隨機數字法)分為5組(各8隻):假手術組(sham)、常溫齣血組(NT)、亞低溫1h組(MH1)、亞低溫2h組(MH2)、亞低溫4h組(MH3).NT組、Sham組體溫控製(37.0±0.2)℃；亞低溫組ICH後即刻快速降至(33.0±0.5)℃併分彆持續1、2、4h.在腦齣血後48 h,各組分彆進行腦含水量、血腦屏障通透性檢測,應用Real-time PCR及Western blot檢測HIF-1α、VEGF mRNA及蛋白.結果 NT組腦含水量、伊文氏藍含量、HIF-1α、VEGF mRNA及蛋白錶達明顯高于sham組(P＜0.01)；MH1組與NT組比,HIF-1α mRNA及蛋白錶達減少(P＜0.05)；MH2組、MH3組與NT組比,上述指標均下調；MH2組與MH3組結果差異無統計學意義.結論 ICH後早期快速的治療性亞低溫可能在轉錄水平下調HIF-1 α mRNA及蛋白錶達,進而抑製VEGF mRNA及蛋白,減輕ICH後腦水腫.低溫2h與4h對腦水腫的改善相同.
목적 관찰불동시정치료성아저온대대서뇌출혈(ICH)후뇌수종급대결양유도인자-1α (HIF-1α)、혈관내피생장인자(VEGF)표체적영향,탐토아저온감경ICH후뇌수종적가능적궤제급방법.방법 채용자체고동맥혈주입우측기저절구제작ICH모형,장40지웅성SD대서,수궤(수궤수자법)분위5조(각8지):가수술조(sham)、상온출혈조(NT)、아저온1h조(MH1)、아저온2h조(MH2)、아저온4h조(MH3).NT조、Sham조체온공제(37.0±0.2)℃；아저온조ICH후즉각쾌속강지(33.0±0.5)℃병분별지속1、2、4h.재뇌출혈후48 h,각조분별진행뇌함수량、혈뇌병장통투성검측,응용Real-time PCR급Western blot검측HIF-1α、VEGF mRNA급단백.결과 NT조뇌함수량、이문씨람함량、HIF-1α、VEGF mRNA급단백표체명현고우sham조(P＜0.01)；MH1조여NT조비,HIF-1α mRNA급단백표체감소(P＜0.05)；MH2조、MH3조여NT조비,상술지표균하조；MH2조여MH3조결과차이무통계학의의.결론 ICH후조기쾌속적치료성아저온가능재전록수평하조HIF-1 α mRNA급단백표체,진이억제VEGF mRNA급단백,감경ICH후뇌수종.저온2h여4h대뇌수종적개선상동.
Objective To investigate the effect of mild therapeutic hypothermia for different lengths of time on cerebral edema and hypoxia-inducible factor 1 α (HIF-1α),vascular endothelial growth factor (VEGF) expressions following intracerebral hemorrhage (ICH) so as to explore possible mechanism for better application of mild hypothermia.Methods ICH models were made in rats by stereotaxically injecting autologous artery blood into right caudate nucleus.Forty male Sprague-Dawley (SD) rats were randomly (random number) divided into 5 groups (n =8 each):sham-operated (sham),normothermic (NT),hypothermic-1 hour (MH1),hypothermic-2 hours (MH2),hypothermic-4 hours (MH3).Normothermic and sham-operated animals were kept at (37.0-± 0.2) ℃ of body temperature.Animals in the hypothermic groups received immediately and rapid cooling after ICH and kept at (33.0 ± 0.5) ℃ of body temperature for 1,2 and 4 hours respectively.Rats were sacrificed at 48 hours after cerebral hemorrhage.Then brain water content and BBB permeability were determined.Quantitative real-time PCR and Western blot were used to analyze the expression of HIF-1α and VEGF.Results The content of brain water,Evans blue concentration in brain,and the mRNA expression and protein levels of HIF-1α and VEGF were noticeably higher in NT group than those in sham group (P ＜0.01).There were statistically significant difference in the expression of HIF-lα mRNA and protein but little difference in other indicators between MH1 group and NT group.Compared with NT group,MH2 group and MH3 group brought about an improvement in BBB permeability and remarkable down-regulation of protein levels and expression of HIF-1 α and VEGF mRNA,whereas there were no statistically significant difference in expression of indicators between the two groups.Conclusions Mild therapeutic hypothermia induced rapidly and immediately after ICH could limit the development of brain edema in rats by down-regulating expression and protein levels of HIF-1 α mRNA,and in turn suppressing the evaluation of VEGF mRNA and protein expression.The brain edema was effectively reduced in animals treated with hypothermia for 2 hours' or 4 hours ' duration with little difference in magnitude of reduction in brain edema between these two modalities of hypothermia.
