依达拉奉对尿激酶溶栓大鼠脑组织基质金属蛋白酶-9表达及出血转化的影响

目的探讨依达拉奉对尿激酶溶栓大鼠脑组织基质金属蛋白-9(MMP-9)表达及脑出血性转化的影响。方法健康雄性Sprague Dawley(SD)大鼠制作大鼠自体血大脑中动脉栓塞模型,制作成功后随机分成3组:尿激酶组、脑缺血组、尿激酶+依达拉奉组;每组20只,另加20只为假手术组。取脑组织进行病理学检查并用免疫组化技术检测MMP-9表达,RT-PCR检测MMP-9mRNA表达。结果各组大鼠脑组织病理学结果:尿激酶组中7只发生脑出血,脑缺血组仅1只有红细胞漏出血,尿激酶+依达拉奉组4只发生脑出血,且出血体积较尿激酶组明显减少。尿激酶组中MMP-9在脑组织中高度表达,尿激酶+依达拉奉组表达相对减少,与脑缺血组及尿激酶组比较,差异有统计学意义(P<0.05)。假手术组大鼠脑组织中微量表达。MMP-9mRNA表达与MMP-9在各组中表达一致。结论依达拉奉能显著降低尿激酶溶栓大鼠脑组织中MMP-9mRNA及MMP-9蛋白表达,并可能降低溶栓后出血转化率。     

依达拉奉对大鼠脑梗死溶栓治疗后MMP-9表达的影响

目的研究依达拉奉对大鼠脑梗死溶栓治疗后脑组织中MMP-9表达及血脑屏障的影响,探讨依达拉奉对脑梗死溶栓治疗后再灌注损伤的保护机制。方法采用SD大鼠自体血栓栓塞法制备大脑中动脉闭塞模型,并将SD大鼠随机分为假手术组、尿激酶溶栓治疗组(UK)、尿激酶+依达拉奉治疗组(UK+ED),12h后分别以免疫组织化学法和比色法对SD大鼠脑组织中MMP-9表达水平和伊文思蓝含量进行测定。结果与尿激酶溶栓治疗组相比,尿激酶+依达拉奉组SD大鼠缺血侧脑组织MMP-9表达水平和EB含量均显著降低,差异具有统计学意义(P值均<0.01)。结论依达拉奉可能通过下调MMP-9表达,减轻血脑屏障的破坏,减轻溶栓后脑缺血再灌注损伤。     

高压氧联合依达拉奉对大鼠脑梗死区AQP9的影响

目的探讨高压氧联合依达拉奉对脑梗死大鼠AQP9表达及脑水肿的影响。方法建立老年SD大鼠大脑中动脉闭塞(MCAQ)模型,随机分为4组:对照组、依达拉奉组、高压氧组和联合组,每组20只。对各组大鼠进行神经功能评分,检测大鼠脑组织内AQP9基因及蛋白的表达、梗死脑组织的含水量,并进行HE染色,观察病理学变化。结果各组大鼠神经功能缺损评分比较显示,联合组明显低于对照组、依达拉奉组及高压氧组;RT-PCR及Western blot检测表明,联合组AQP9的mRNA蛋白表达及梗死区脑组织含水量明显低于脑梗死组、依达拉奉组及高压氧组(P0.05);HE染色结果显示,高压氧组、依达拉奉组较对照组炎性浸润及水肿减轻,联合组比高压氧组、依达拉奉组又有明显缓解。结论高压氧联合依达拉奉治疗可促进脑梗死大鼠神经功能的恢复。     

依达拉奉预处理对大鼠脑缺血-再灌注损伤的保护机制

目的探讨依达拉奉预处理对大鼠局灶性脑缺血-再灌注损伤的保护机制。方法将36只SD大鼠随机分为假手术组、缺血-再灌注组和依达拉奉组。依达拉奉组术前给予60 mg/(kg.d)的依达拉奉灌胃,共3 d。采用大脑中动脉线栓法制备大鼠缺血-再灌注损伤模型。比较各组神经功能缺损评分、脑梗死体积、血清神经元特异性烯醇化酶(NSE)含量及脑组织白介素-1β(IL-1β)和肿瘤坏死因子(TNF-α)含量。结果与缺血-再灌注组比较,依达拉奉组的神经功能缺损评分显著下降,脑梗死灶体积显著缩小,血清NSE含量明显降低(均P<0.01);脑组织IL-1β和TNF-α含量显著降低(P<0.05～0.01)。结论依达拉奉预处理可减少大鼠脑缺血-再灌注损伤后脑组织IL-1β和TNF-α表达,保护脑组织。     

亚低温疗法联合依达拉奉对大鼠脑缺血再灌注损伤的保护作用

目的探讨亚低温疗法联合依达拉奉对大鼠脑缺血再灌注损伤后的保护作用。方法采用线栓法建立局灶性脑缺血再灌注模型,缺血6h后再灌注,并分为假手术组、模型组、依达拉奉组、亚低温联合依达拉奉组,再灌注24h后进行神经功能缺损评分,采用TTC染色测定脑梗死体积和用免疫组化的方法检测Bax和Bcl-2的阳性细胞数。结果与模型组比较,依达拉奉未能减少脑梗死体积,但能通过下调Bax及上调Bcl-2减少细胞的凋亡,对脑细胞有保护作用;与模型组、依达拉奉组比较,亚低温联合依达拉奉组能通过上调Bcl-2及下调Bax明显降低大鼠神经缺陷评分及减少脑梗死体积。结论亚低温疗法联合依达拉奉对大鼠脑缺血再灌注损伤具有很好的保护作用。     

丁苯酞软胶囊联合依达拉奉注射液治疗急性脑梗死的效果观察

目的：观察丁苯酞软胶囊联合依达拉奉注射液治疗急性脑梗死的疗效。方法急性脑梗死患者60例随机分为依达拉奉组和联合治疗组,每组30例。2组均采用相同的基础治疗和对症处理。依达拉奉组静滴依达拉奉注射液30mg＋生理盐水150mL,2次／d,连用14d;联合治疗组给予丁苯酞软胶囊空腹口服,2粒（0.2g）／次,3次／d,静滴依达拉奉注射液30mg＋生理盐水150mL,2次／d,均连续用14d。分别在治疗前及治疗第15天进行MRI检查评估患者脑梗死体积,并进行神经功能缺损评分（NIHSS）。结果治疗第15天时,联合治疗组脑梗死体积显著小于依达拉奉组（P＜0.01）,2组NIHSS评分与治疗前比较均明显降低,差异有统计学意义（P＜0.05）;2组NIHSS评分比较,联合治疗组明显低于依达拉奉组（P＜0.05）;显效率明显高于对照组,差异有统计学意义（P＜0.05）;2组不良反应发生率比较差异无统计学意义（P＞0.05）。结论丁苯酞软胶囊联合依达拉奉注射液治疗急性脑梗死,可明显缩小脑梗死体积,显著改善神经功能,减少致残率,疗效确切,无严重不良反应,值得临床推广应用。     

依达拉奉对急性脑出血患者血浆S-100β蛋白表达及神经功能的影响

目的 探讨依达拉奉对急性脑出血患者血浆S-100β蛋白表达及神经功能的影响.方法 73例急性脑出血患者随机分为依达拉奉组(37例)和常规组(36例).依达拉奉组在常规治疗基础上加用依达拉奉注射液30 mg于100 ml生理盐水中静脉滴注,每日2次,连续14 d.分别于脑出血后2d(治疗前)、6d、11d时进行血浆S-100β蛋白检测和斯堪的纳维亚卒中量表(SSS)评分.结果与30名健康对照者(正常对照组)进行比较.结果 与正常对照组比较,依达拉奉组和常规组血浆S-100β蛋白水平明显升高(均P＜0.05).与依达拉奉组比较,常规组脑出血后6d、11d时血浆S-100β蛋白水平明显升高(均P＜0.05).依达拉奉组和常规组脑出血后6d时血浆S-100β蛋白水平最高,且明显高于治疗前(均P＜0.05).与常规组比较,依达拉奉组治疗后6d、11d时SSS评分均明显升高(均P＜0.05).依达拉奉组和常规组脑出血后6d时SSS评分最低,且明显低于治疗前(均P＜0.05).直线相关分析显示,依达拉奉组和常规组血浆S-100β蛋白水平与SSS评分均呈负相关(r=-0.9018,P＜0.01;r=-0.8483,P＜0.01).结论 急性脑出血患者的血浆S-100β蛋白表达水平可以反映神经功能的损害程度.依达拉奉可明显降低急性脑出血患者血浆S-100β蛋白表达并能改善神经功能缺损.     

依达拉奉对急性脑梗死患者血清血管内皮生长因子和肿瘤坏死因子水平的影响

目的 探讨依达拉奉对急性脑梗死患者血清血管内皮生长因子(VEGF)和肿瘤坏死因子(TNF)-α水平的影响.方法 84例急性脑梗死患者随机分为依达拉奉组和对照组;在脑梗死常规治疗的基础上,依达拉奉组加用依达拉奉60 mg/d静脉滴注14 d.治疗前、治疗后14 d及28 d应用改良爱丁堡斯堪的那维亚量表( SSS)对患者进行临床神经功能缺损程度评分;应用酶联免疫吸附测定法检测患者发病3d、7d及14 d血清VEGF及TNF-α水平.结果 两组患者治疗14 d及28 d时SSS评分均较治疗前明显降低(P＜0.05 ～0.01),依达拉奉组各时间点SSS评分明显低于对照组(均P＜0.05).两组血清VEGF及TNF-α水平发病后各时间点较正常值明显增高,发病第7d时明显高于第3d和第14 d(均P＜0.05);依达拉奉组各时间点血清VEGF水平明显低于对照组(均P＜0.01);两组各时间点血清TNF-α水平差异无统计学意义.结论 依达拉奉可明显降低急性脑梗死患者血清VEGF水平,减轻脑梗死后自由基导致的脑损害.     

依达拉奉对脑出血大鼠脑组织含水量、肿瘤坏死因子-α含量、血清基质金属蛋白酶-9水平和超氧化物歧化酶活性的影响

目的 探讨依达拉奉对脑出血大鼠脑组织含水量、肿瘤坏死因子-α(TNF-α)含量、血清基质金属蛋白酶-9 (MMP-9)水平和超氧化物歧化酶(SOD)活性的影响.方法 36只SD大鼠随机分为假手术组、脑出血模型组和依达拉奉治疗组,每组12只大鼠.采用自体血注入法制作大鼠脑出血模型.依达拉奉治疗组术后予以依达拉奉注射液3 mg/kg腹腔注射治疗,每12 h注射1次,直至处死前12 h.术后72 h时,采用于湿重法检测各组脑组织含水量,双抗体夹心酶联免疫吸附(ELISA)法检测脑组织TNF-α含量及血清MMP-9水平,黄嘌呤氧化酶法检测血清SOD活性.结果 与脑出血模型组比较,依达拉奉治疗组及假手术组大鼠脑组织含水量及TNF-α含量明显减少,血清MMP-9水平明显降低,血清SOD活性明显增高(P ＜0.05～0.01).与假手术组比较,依达拉奉治疗组脑组织含水量差异具有统计学意义(P＜0.05).脑出血模型组大鼠脑组织含水量与血清MMP-9水平呈正相关(r=0.956,P=0.003);与血清SOD活性呈负相关(r=-0.945,P=0.004).结论 依达拉奉能降低脑出血大鼠的脑组织含水量、TNF-α含量和血清MMP-9水平,以及提高SOD的活性;其可能通过这些机制对脑出血大鼠的脑组织起保护作用.     

依达拉奉对局灶性脑缺血大鼠神经功能恢复及海马病理形态学改变的影响

目的 探讨大鼠局灶性脑缺血后神经功能恢复及海马病理形态学改变,评价依达拉奉的干预作用.方法 126只雄性SD大鼠随机分为3组:假手术组(A组,6只),生理盐水组(B组,MCAO后6h、12h、24h、48h、72h、5d、7d7时点,各6只),依达拉奉处理组(C组,同B组),术后即刻予以依达拉奉干预.行神经功能缺损评分测定;TTC染色观察脑梗死体积改变;用HE染色方法观察病理形态学改变.结果 术后进行神经缺损评分发现,由于麻醉和手术创伤的影响,假手术组术后出现6～24h神经功能减退.与假手术组相比,在6～24h时间段盐水组神经功能下降明显(P＜0.05).依达拉奉组神经功能明显好于盐水组(P＜0.05).术后7d盐水组和依达拉奉组神经功能基本恢复.同时,在依达拉奉组和盐水组中,缺血24h脑梗死体积最大;与盐水组相比,术后6～24h依达拉奉组脑梗死体积明显减小(P＜0.05).HE染色显示术后6h在脑缺血区神经元细胞无明显改变,6h后缺血区脑组织逐渐出现肿胀与坏死;在依达拉奉组,脑水肿和神经元坏死病理损害明显较轻,在假手术组,脑组织无明显改变.结论 依达拉奉具有改善神经功能缺损、缩小脑梗死体积和减轻缺血性病理损害程度的作用;研究还提示依达拉奉对缺血性脑卒中早期神经功能恢复具有十分重要的临床意义.     

rt-PA应用后MMP-2、MMP-9表达的改变及Neuroserpin的影响

目的 观察重组组织型纤溶酶原激活剂(rt-PA)对血管再通后基质金属蛋白酶-2(MMP-2)、MMP-9表达的影响以及神经源性丝氨酸蛋白酶抑制剂(neuroserpin,NSP)的干预作用。方法 应用易卒中型肾血管性高血压大鼠复制大脑中动脉缺血模型,缺血3 h后再灌注并静脉注射rt-PA,于预组在应用rt-PA前脑内注射NSP,1天后处死,常规病理检查,并应用免疫组织化学和原位杂交的方法观察MMP-2、MMP-9在脑组织的表达。结果 缺血再灌注后MMP-2、MMP-9表达均升高;应用rt-PA后可见缺血再灌注区有灶性出血及红细胞漏出,同时使MMP-9进一步升高,但对MMP-2影响不大;应用rt-PA的同时使用NSP可以减轻缺血损伤,减少出血的发生,并使升高的MMP-9减少至接近正常水平,但NSP可以使MMP-2表达略有升高。结论 rt-PA溶栓后出血转化的发生可能与MMP-9表达增加有关,溶栓时联合应用NSP可能通过降低rt-PA所致的MMP-9表达上调而减轻溶栓治疗的出血并发症。     

Uric acid reduces brain damage and improves the benefits of rt-PA in a rat model of thromboembolic stroke.

Uric acid is a natural antioxidant that protects the brain in a model of transient focal ischemia in rats. Here we sought to investigate whether uric acid was protective in a model of thromboembolic brain ischemia in rats, and whether the global benefit of recombinant tissue plasminogen activator (rt-PA) was improved by the combined treatment. Adult male Sprague-Dawley rats underwent either ischemia by thromboembolic middle cerebral artery occlusion (MCAO) or sham operation. Uric acid (16 mg/kg) was injected intravenously (i.v.). 20 mins after MCAO, whereas rt-PA (10 mg/kg) was administered i.v. at 3 h. A group of rats received the combined treatment. Rats underwent two neurologic examinations (30 mins and 24 h after MCAO). At 24 h, infarct volume was measured and brain neutrophil infiltration and protein tyrosine nitration were assessed. Treatment with either uric acid or rt-PA reduced infarct volume versus controls (P<0.05). The protective effect against brain ischemia was greater after cotreatment of uric acid with rt-PA (P<0.001), which added further benefit to rt-PA alone (P<0.05). The neurologic score worsened during the first 24 h in treatment controls, whereas it improved in rats receiving uric acid and/or rt-PA. Uric acid strongly reduced ischemia-induced tyrosine nitration, but it was more effective alone than combined with rt-PA, suggesting that reperfusion enhances nitrotyrosine formation. All treatments reduced postischemic brain neutrophil infiltration. These results show that uric acid administered early after thromboembolic stroke is neuroprotective in the rat brain, as it reduces infarct volume, ameliorates the neurologic function, attenuates the inflammatory response, and extends the benefits of rt-PA.     

低剂量坎地沙坦对小鼠脑梗死使用重组组织型纤溶酶原激活剂溶栓的出血并发症的影响及机制

目的探讨低剂量坎地沙坦(Cand)对小鼠脑梗死用重组组织型纤溶酶原激活剂(rt-PA)溶栓出血并发症的影响及机制。方法160只小鼠随机分为对照组(56只)、rt-PA组(52只)、rt-PA+Cand组(52只)。用线栓法建立大脑中动脉栓塞(MCAO)模型,rt-PA组和rt-PA+Cand组在MCAO开始后2 h股静脉注射rt-PA(10 mg/kg),rt-PA+Cand组MCAO术前口服Cand 2周[0.5 mg/(kg·d)]。术后24 h评价各组神经功能、脑出血转化情况、出血转化体积及伊文思蓝渗出浓度,定量反转录聚合酶连锁反应法检测脑组织基质金属蛋白酶-9(MMP-9)、Claudin-5基因表达变化,免疫荧光法检测MMP-9、Claudin-5蛋白表达变化,Western blotting法检测脑组织血浆激肽释放酶(Pkal)、血管紧张素Ⅱ(AngⅡ)受体(AT1R)及缓激肽受体(B2R)蛋白表达变化。结果对照组及rt-PA+Cand组一般功能损伤评分、局灶功能损伤评分、出血转化评分、血红蛋白水平及伊文思蓝渗出浓度显著低于rt-PA组(均P<0.01)。与rt-PA组比较,对照组及rt-PA+Cand组MMP-9 mRNA相对表达量及阳性细胞率显著降低,Claudin-5 mRNA相对表达量及阳性细胞率显著升高(P<0.05~0.01)。对照组及rt-PA+Cand组Pkal、AT1R、B2R表达显著低于rt-PA组(P<0.05~0.01)。结论低剂量Cand可以一定程度上预防并减轻小鼠脑缺血再灌注后使用rt-PA的出血并发症,这可能是通过减少AngⅡ-AT1R/Pkal表达实现的。     

A non-steroidal anti-inflammatory agent provides significant protection during focal ischemic stroke with decreased expression of matrix metalloproteinases

The present study was designed to investigate whether the neuroprotective effect of nimesulide was mediated by inhibiting expression of matrix metalloproteinase-9 (MMP-9) and/or matrix metalloproteinase-2 (MMP-2) in a rat model of thrombolytic reperfusion after the embolic focal cerebral ischemia (FCI). It was found that nimesulide at therapeutically relevant doses (3, 6 and 12 mg/kg) decreased neurological deficits, infarct volume, brain index and brain water content in a dose-dependent manner. Hemorrhagic transformation was reduced by 64% with treatment of 12 mg/kg nimesulide. Quantitative analysis of immunohistochemical staining of brain slices showed that the neuron number expressing MMP-9 and MMP-2 increased in the model animals treated with vehicle (p<0.01 vs sham group), and significantly decreased in nimesulide-treated animals (p<0.05 or p<0.01 vs vehicle group). Our results demonstrate that nimesulide significantly reduces the degree of neuronal injury and hemorrhage transformation caused by thrombolytic reperfusion after the embolic FCI, and that inhibition of MMP-9 and MMP-2 expression contributes at least in part to the neuroprotection.     

中性粒细胞明胶酶相关载脂蛋白在大鼠脑出血后继发性脑损伤中的作用研究

目的探讨中性粒细胞明胶酶相关载脂蛋白(NGAL)在脑出血(ICH)后继发性脑损伤中的作用。方法采用Ⅶ胶原酶制作ICH模型,将90只雄性SD大鼠随机分为3组:正常对照组(10只)、假手术组(40只)和ICH模型组(40只)。分别在ICH后6 h、24 h、72 h和7 d四个时间点对大鼠进行神经功能缺损评分;用免疫组化及RT-q PCR来观察不同时间点脑组织NGAL及MMP-9表达情况。结果免疫组化及RT-q PCR结果显示ICH后模型组各时间点均可见大量NGAL、MMP-9阳性细胞及NGAL mRNA表达,且明显高于正常组及假手术组(P0.05)。ICH模型组NGAL与MMP-9蛋白表达呈正相关(P0.01)。ICH模型组NGAL、MMP-9蛋白表达均与大鼠神经功能缺损评分呈正相关(P0.05)。结论 ICH后NGAL表达明显增加,提示NGAL可能参与了脑出血后继发性脑损伤,并可能通过调节MMP-9的活性从而发挥作用,但NGAL是否为MMP-9的上游调控因子尚有待进一步研究。     

阿托伐他汀钙对实验性脑缺血MMP-9表达变化的影响

目的探讨阿托伐他汀钙对大鼠脑缺血再灌注后脑组织中MMP-9mRNA及蛋白表达的影响。方法采用大脑中动脉线栓法制备脑缺血再灌注模型,参考Longa5分制法在动物麻醉清醒后进行评分,应用原位杂交和免疫组化法检测MMP-9mRNA及蛋白表达。结果大鼠脑缺血再灌注后缺血脑组织中MMP-9mRNA和蛋白表达增加(P<0.01),24h达高峰;阿托伐他汀钙干预治疗后能减少缺血脑组织中MMP-9mRNA和蛋白表达(P<0.05);降低神经功能缺损评分(P<0.05)。结论阿托伐他汀钙能抑制大鼠脑缺血再灌注后脑组织中MMP-9mRNA及蛋白表达,减轻缺血再灌损伤。     

参附注射液对大鼠脑缺血再灌注损伤后MMP-9和TIMP-1表达的影响

目的 观察参附注射液对大鼠脑缺血再灌注后基质金属蛋白酶-9(MMP-9)及基质金属蛋白酶抑制剂-1(TIMP-1)表达的影响,探讨参附注射液的脑保护机制. 方法 Wistar大鼠90只按随机数字表法分为假手术组、参附治疗组、模型组,每组30只.后2组大鼠采用线栓法经左侧颈外一颈内动脉插线建立脑缺血再灌注模型,并分别于再灌注时静脉注射等量参附注射液和生理盐水.每组根据缺血时间分为0.5、1、1.5h3个亚组,每亚组10只,再灌注24h后将大鼠处死以干湿重法检测缺血再灌注侧脑组织含水量,Western blotting检测脑组织中MMP-9和TIMP-1的表达.结果 模型组与参附治疗组在脑缺血不同时间脑组织含水量、MMP-9、TIMP-1的表达均高于假手术组,并且随着缺血时间的增加,脑组织含水量和MMP-9的表达增加,差异有统计学意义(P＜0.05);与模型组比较,参附治疗组在不同脑缺血时间脑组织的含水量、MMP-9的表达较低,而TIMP-1蛋白的表达较高,差异均有统计学意义(P＜0.05). 结论 参附注射液可能通过调节MMP-9、TIMP-1的表达发挥抗脑水肿的作用.     

Recombinant human tissue plasminogen activator protects the basal lamina in experimental focal cerebral ischemia

While recombinant tissue plasminogen activator (rt-PA) is successfully used in human ischemic stroke, it may also cause hemorrhagic complications. Animal experiments have shown that hemorrhages are related to microvascular basal lamina damage. We investigated the effects of different doses of rt-PA on the brain microvasculature. Experimental cerebral ischemia in rats was induced for 3 h and followed by 24 h reperfusion (suture model). Each group of rats (n = 6) received either treatment (0.9, 9, or 18 mg rt-PA/kg body weight) or saline (control group) at the end of ischemia. The loss of microvascular basal lamina antigen collagen type IV was measured by Western blot of the ischemic and non-ischemic basal ganglia and cortex. Compared with the contralateral non-ischemic area, collagen type IV was significantly reduced in the ischemic area: (basal ganglia/cortex) 43% +/- 9% / 64% +/- 4 %. Low/moderate doses of rt-PA had a protective effect: 0.9 mg 79% +/- 3% / 89% +/- 6%, 9 mg 72% +/- 9%/ 81% +/- 12% (p < 0.05). Higher doses of rt-PA (18 mg) had a similar effect as seen in untreated controls: 57% +/- 11% / 59% +/- 9% (p < 0.05, Anova). MMP-9 and MMP-2, measured by gelatine zymography, steadily increased over higher doses of rt-PA: MMP-9 (basal ganglia/cortex): control 115% +/- 4% / 123% +/- 3% compared with 18 mg rt-PA 146% +/- 5%/ 162% +/- 6% (p < 0.05) and MMP-2: control 109% +/- 4%/ 116% +/- 5% and 18 mg rt-PA 222% +/- 15%/ 252% +/- 2% (p < 0.05). Low to moderate doses of rt-PA protect the microvascular basal lamina, whereas high doses of rt-PA have the opposite effect, probably due to increased coactivation of MMP-2 and MMP-9.     

脑血疏口服液对大鼠脑缺血再灌注损伤后血脑屏障的影响

目的 探讨脑血疏口服液对大鼠脑缺血再灌注损伤后血脑屏障的影响。方法 将120只SD大鼠随机分为3组:假手术组、对照组,脑血疏组; 采用线栓法建立大鼠左侧大脑中动脉闭塞再灌注模型,缺血2 h后拔出线栓,恢复灌注24 h; 采用Longa FZ 5级评分法进行大鼠神经功能缺损评分; TTC染色计算脑梗死体积百分比; 运用干-湿重法测脑含水率; 通过伊文思蓝( EB)含量反映血脑屏障的损伤程度; 免疫组化检测基质金属蛋白酶-9(MMP-9)的表达水平。结果(1)假手术组大鼠在神经功能缺损评分、脑梗死体积、脑含水率均低于对照组(P<0.01); 脑组织中EB含量和MMP-9表达水平较对照组低(P<0.01);(2)脑血疏组大鼠的神经功能缺损评分较低、脑梗死体积较小,脑水肿程度较轻; EB含量和MMP-9表达水平均较对照组明显减少(P<0.01)。结论 脑血疏口服液对大鼠脑缺血再灌注损伤后血脑屏障具有保护作用,其机制可能是通过抑制MMP-9的表达。     

Tumor necrosis factor-alpha neutralization reduced cerebral edema through inhibition of matrix metalloproteinase production after transient focal cerebral ischemia.

After focal cerebral ischemia, tumor necrosis factor-alpha deteriorates cerebral edema and survival rate. Therefore, tumor necrosis factor-alpha neutralization could reduce cerebral microvascular permeability in acute cerebral ischemia. Left middle cerebral artery occlusion for 120 mins followed by reperfusion was performed with the thread method under halothane anesthesia in Sprague-Dawley rats. Antirat tumor necrosis factor-alpha neutralizing monoclonal antibody with a rat IgG Fc portion (15 mg/kg) was infused intravenously right after reperfusion. Stroke index score, infarct volume, cerebral specific gravity, and the endogenous expression of tumor necrosis factor-alpha, matrix metalloproteinase (MMP)-2, MMP-9, and membrane type 1-MMP in the brain tissue were quantified in the ischemic and matched contralateral nonischemic hemisphere. In the antitumor necrosis factor-alpha neutralizing antibody-treated rats, infarct volume was significantly reduced (P=0.014, n=7; respectively), and cerebral specific gravity was dramatically increased in the cortex and caudate putamen (P<0.001, n=7; respectively) in association with a reduction in MMP-9 and membrane type 1-MMP upregulation. Tumor necrosis factor-alpha in the brain tissue was significantly elevated in the ischemic hemisphere 6 h after reperfusion in the nonspecific IgG-treated rats (P=0.021, n=7) and was decreased in the antitumor necrosis factor-alpha neutralizing antibody-treated rats (P=0.001, n=7). Postreperfusion treatment with antirat tumor necrosis factor-alpha neutralizing antibody reduced brain infarct volume and cerebral edema, which is likely mediated by a reduction in MMP upregulation.