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目的探讨高压氧(HBO)治疗对大鼠蛛网膜下腔出血(SAH)后迟发性脑血管痉挛(DCVS)的影响及机制。方法将54只健康成年大鼠随机分为假手术组(sham)、蛛网膜下腔出血组(SAH)、蛛网膜下腔出血后高压氧治疗组(SAH+HBO)。通过枕大池二次注血法建立蛛网膜下腔出血大鼠动物模型。收集大鼠血浆、脑脊液、大脑右侧中动脉标本,采用显微图像分析系统测量各组大脑中动脉内径及血管壁厚度,用硝酸还原酶法测定各组血浆及脑脊液中一氧化氮(NO)水平,用酶联免疫吸附法(ELISA)测定各组血浆及脑脊液中内皮素-1(ET-1)水平。结果 (1)蛛网膜下腔出血组(SAH组)术后大脑中动脉内径缩小、管壁厚度增加。而SAH组经高压氧治疗后中动脉内径在术后3 d、5 d大于SAH组,但小于假手术组(Sham组);管壁厚度在术后3 d、5 d小于SAH组,但大于假手术组(Sham组),差异有统计学意义(P<0.05)。(2)SAH组术后1 d、3 d、5 d血浆及脑脊液一氧化氮水平降低,而经高压氧治疗后则升高。SAH组术后3 d、5 d血浆及脑脊液内皮素-1水平增高,经高压氧治疗后则降低,差异均有统计学意义(P<0.05)。结论高压氧治疗能通过增高大鼠蛛网膜下腔出血后血浆及脑脊液一氧化氮水平,降低血浆及脑脊液内皮素-1水平而减轻脑血管痉挛程度,从而改善脑损伤。
Objective To investigate the effects and mechanisms of hyperbaric oxygen therapy (HBO) on delayed cerebral vasospasm (DCVS) after subarachnoid hemorrhage (SAH) in rats. Methods Fifty - four healthy adult rats were randomly divided into sham group, subarachnoid hemorrhage group (SAH) and hyperbaric oxygen group (SAH + HBO group) after subarachnoid hemorrhage. The animal model of subarachnoid hemorrhage was established by the secondary injection method of occipital cistern. The plasma, cerebrospinal fluid and the right middle cerebral artery of rat were collected. The diameter of middle cerebral artery and the thickness of blood vessel wall of each group were measured by microscopic image analysis system. The contents of nitric oxide (NO) in plasma and cerebrospinal fluid Level, and the level of ET-1 in plasma and cerebrospinal fluid of each group was measured by enzyme-linked immunosorbent assay (ELISA). Results (1) Subarachnoid hemorrhage group (SAH group) reduced the diameter of the middle cerebral artery and increased the thickness of the wall. In the SAH group, the diameter of the middle artery after hyperbaric oxygen treatment was larger than SAH group on the 3rd day and 5th day after operation, but smaller than that of sham group (Sham group). The wall thickness of SAH group was less than that of SAH group on the 3rd day and 5th day after operation, Sham operation group (Sham group), the difference was statistically significant (P <0.05). (2) The level of nitric oxide in plasma and cerebrospinal fluid in SAH group decreased on the 1st, 3rd, 5th day after operation, but increased after hyperbaric oxygen therapy. The levels of endothelin-1 in plasma and cerebrospinal fluid in SAH group increased at 3 d and 5 d after operation, but decreased after hyperbaric oxygen treatment (P <0.05). Conclusion Hyperbaric oxygen therapy can improve brain injury by increasing nitric oxide level in plasma and cerebrospinal fluid after subarachnoid hemorrhage in rats and decreasing endothelin-1 level in plasma and cerebrospinal fluid to reduce cerebral vasospasm.