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目的 :观察胰岛素对脑缺血再灌注损伤的治疗作用并探讨其作用机制。方法 :制备易卒中型肾血管性高血压大鼠 ( RHRSP) ,用线栓法复制大脑中动脉阻塞 ( MCAO)模型。实验一 :造成缺血 6h再灌注 1 8h,治疗组于不同时程使用胰岛素 ,测定脑梗死体积及脑水肿的变化。实验二 :造成缺血 2 h再灌 1、3、5天 ,治疗组于再灌注后立即使用胰岛素 ,采用 TUNEL法原位标记 DNA片段 ,检测 TUNEL阳性细胞的变化。结果 :治疗组的梗死灶体积及其占全大脑体积百分比、两半球体积差值显著减小 ,TUNEL阳性细胞亦明显减少 ( P<0 .0 5)。结论 :胰岛素能减轻脑缺血再灌注损伤 ,早期用药效果更好 ,减少再灌注后细胞损伤很可能是其作用机制之一。
Objective: To observe the therapeutic effect of insulin on cerebral ischemia-reperfusion injury and to explore its mechanism. Methods: Stroke - prone renovascular hypertensive rats (RHRSP) were prepared and the middle cerebral artery occlusion (MCAO) model was reproduced by thread occlusion. Experiment 1: After ischemia for 6h and reperfusion for 18h, the treatment group used insulin at different time points to determine the changes of cerebral infarction volume and brain edema. Experiment 2: After 1h, 3h and 5h after reperfusion, the rats in the treatment group were treated with insulin immediately after reperfusion. DNA fragments were labeled by TUNEL in situ and the changes of TUNEL positive cells were detected. Results: The volume of infarction and its percentage of total brain volume in the treatment group were significantly lower than those in the control group (P <0.05). The difference between the two hemispheres was significantly reduced and TUNEL positive cells were also significantly decreased (P <0.05). CONCLUSION: Insulin can relieve cerebral ischemia-reperfusion injury, and better effect of early medication and reduce cell injury after reperfusion is likely to be one of the mechanisms.