Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul, South Korea.
J Neurosurg Anesthesiol. 2013 Jan;25(1):43-50. doi: 10.1097/ANA.0b013e31826ca3bc.
The aim of this study was to determine whether a combination of sevoflurane postconditioning and albumin provides additive neuroprotective effects after transient global cerebral ischemia in rats.
Forty-three rats were assigned to 4 groups: the control group (group C; n=13; 3 died) received no treatment. The albumin group (group A; n=10) received 2 g/kg of albumin for 5 minutes after ischemia. The sevoflurane postconditioning group (group P; n=10) underwent 2 sevoflurane inhalations after ischemia. Each inhalation consisted of 5 minutes of 2.5% sevoflurane and a subsequent washout time of 5 minutes. The sevoflurane postconditioning plus albumin group (group PA; n=10) received additional albumin during sevoflurane postconditioning after ischemia. In all groups, ischemia was induced by a bilateral common carotid artery occlusion along with hemorrhagic hypotension and was maintained for 10 minutes. Histologic and neurobehavioral outcomes were measured 7 days after ischemia in CA1 pyramidal cells of the rat hippocampus.
Groups A, P, and PA showed an improved neurological outcome and contained more viable cells in the hippocampal CA1 area compared with group C (P<0.05). The number of apoptotic cells was significantly reduced in group PA compared with group C (P<0.01). There was a significant difference in the Bcl-2, an antiapoptotic protein, expression between group C and other groups (P<0.01) and between group A or P and group PA (P<0.05).
A combination of sevoflurane postconditioning and albumin increased the level of Bcl-2 expression compared with sevoflurane postconditioning or albumin alone, suggesting their combination might provide additional neuroprotection by decreasing apoptosis.
本研究旨在确定七氟醚后处理联合白蛋白是否在大鼠短暂全脑缺血后提供附加的神经保护作用。
43 只大鼠分为 4 组：对照组（C 组，n=13；3 只死亡）未给予任何治疗。白蛋白组（A 组，n=10）在缺血后给予 2 g/kg 白蛋白 5 分钟。七氟醚后处理组（P 组，n=10）在缺血后进行 2 次七氟醚吸入。每次吸入包括 5 分钟 2.5%七氟醚和随后的 5 分钟洗脱时间。七氟醚后处理联合白蛋白组（PA 组，n=10）在缺血后七氟醚后处理期间给予额外的白蛋白。在所有组中，通过双侧颈总动脉闭塞伴出血性低血压诱导缺血，持续 10 分钟。缺血后 7 天测量大鼠海马 CA1 锥体神经元的组织学和神经行为学结果。
A、P 和 PA 组的神经功能结果改善，海马 CA1 区存活细胞增多，与 C 组相比（P<0.05）。PA 组的凋亡细胞数量明显低于 C 组（P<0.01）。与 C 组相比，Bcl-2（一种抗凋亡蛋白）的表达在 C 组和其他组之间存在显著差异（P<0.01），在 A 组或 P 组与 PA 组之间也存在显著差异（P<0.05）。
与单独使用七氟醚后处理或白蛋白相比，七氟醚后处理联合白蛋白增加了 Bcl-2 的表达水平，表明它们的联合可能通过减少细胞凋亡提供额外的神经保护作用。
