Department of Emergency Neurology, Affiliated Hospital of Guizhou Medical University, Guizhou, China.
Department of Emergency Neurology, Affiliated Hospital of Guizhou Medical University, Guizhou, China.
World Neurosurg. 2022 Sep;165:e265-e275. doi: 10.1016/j.wneu.2022.06.018. Epub 2022 Jun 10.
This study aimed to explore the effects of minimally invasive surgery (MIS) in combination with rosiglitazone (RSG) on intracerebral hemorrhage (ICH) and determine the optimal time window.
An ICH rabbit model was constructed using the injection of autologous arterial blood and then treated with RSG, MIS, and MIS combined with RSG at 6, 12, 18, and 24 hours. Thereafter, rabbits that underwent different treatments were used to measure the neurological deficit score, brain water content, and glutamate content. Expression of peroxisome proliferator-activated receptor γ (PPARγ) and CD36 in the different groups was detected using real-time quantitative polymerase chain reaction and Western blotting. In addition, oxidative stress-related and inflammation-related genes were examined.
Brain computed tomography indicated that an ICH rabbit model was successfully established. Compared to those in the control rabbits, the neurological deficit scores, brain water content, and glutamate content in the ICH rabbits were significantly increased at each time window (P < 0.05), while they were decreased at each time window after MIS combined with RSG treatment and declined to the lowest at 6 hours. Additionally, ICH significantly upregulated PPARγ and CD36 expression (P < 0.05). Moreover, superoxide dismutase content decreased after ICH, and nitric oxide synthase 2, tumor necrosis factor-alpha, interleukin-6, and interleukin-1 beta mRNA expression was upregulated, whereas MIS combined with RSG treatment reversed the levels caused by ICH.
Evacuation of MIS hematoma combined with RSG infusion at an early stage (6 hours) may attenuate secondary brain damage caused by ICH by regulating the PPARγ/CD36 pathway.
本研究旨在探讨微创手术（MIS）联合罗格列酮（RSG）对脑出血（ICH）的影响，并确定最佳时间窗。
采用自体动脉血注射法构建 ICH 兔模型，然后分别在 6、12、18 和 24 小时给予 RSG、MIS 和 MIS 联合 RSG 治疗。此后，对不同治疗组的兔进行神经功能缺损评分、脑含水量和谷氨酸含量测定，并采用实时定量聚合酶链反应和 Western blot 检测各组过氧化物酶体增殖物激活受体γ（PPARγ）和 CD36 的表达。此外，还检测了氧化应激相关和炎症相关基因。
脑计算机断层扫描表明成功建立了 ICH 兔模型。与对照组相比，ICH 兔在每个时间窗的神经功能缺损评分、脑含水量和谷氨酸含量均显著升高（P<0.05），而 MIS 联合 RSG 治疗后各时间窗均降低，并在 6 小时时降至最低。此外，ICH 显著上调了 PPARγ 和 CD36 的表达（P<0.05）。而且，ICH 后超氧化物歧化酶含量降低，诱导型一氧化氮合酶 2、肿瘤坏死因子-α、白细胞介素-6 和白细胞介素-1βmRNA 表达上调，而 MIS 联合 RSG 治疗则逆转了 ICH 引起的这些变化。
早期（6 小时）清除 MIS 血肿联合 RSG 输注可能通过调节 PPARγ/CD36 通路减轻 ICH 引起的继发性脑损伤。
