沙土鼠全脑缺血控制性低流量灌注的促神经功能康复研究

目的动态研究严重脑外伤时不同灌注时间和灌注量对全脑组织缺血损害的恢复程度和凋亡基因的表达，以探明控制性再灌注的神经功能康复作用。方法沙土鼠随机分5组，实验组夹闭两侧颈总动脉，造成沙土鼠全脑缺血模型，夹闭10min后，开放10min，开放不同脑血流量(1／4，1／2，1／1)和单纯血液稀释后分别观察缺血海马CA区凋亡基因的表达及缺血区大脑半球的改善状况，梯度灌注后行全脑缺血后神经功能评分对比。结果开放10min，1／2脑血流量时Bel—x／1基因明显上调，海马CA区缺血损害改善最明显，凋亡细胞减少，神经功能评分最高。开放10min，全脑血流量一次性开放时海马CA区损害最严重，凋亡明显，神经功能评分最低。结论(1)控制性再灌注有较好的抗神经元细胞凋亡和神经恢复功能作用；(2)低流量灌注有明显改善脑缺血的作用。

Study of neural function rehabilitation by using low blood flow controlled reperfusion after gerbil global cerebral ischemia

Objective To evaluate the effect of controlled reperfusion (CR) in injury recovery and apoptotic genes expression after gerbil global ischemic insults so as to ascertain the role of CR in neural function rehabilitation. Methods The gerbil global ischemic models were made by occluding bilateral carotid artery every 10 minutes and randomly divided into five groups. Posterior to reperfusion for 10 minutes and different reperfusion flow (1/4,1/2,1/1), the apoptotic gene expression in hippocampus CA region and neural function rehabilitation in the ischemic hemisphere were observed. The post global ischemic neural function score was compared after gradient reperfusion. Results Reperfusion for 10 minutes, Bcl-x/l gene expression was highly increased, with significant improvement of ischemic damage in, less apoptotic cells and the highest score for neural function at 1/2 blood flow. However, when reperfusion for 10 minutes, the hippocampus CA region was insulted with the most severely ischemic damage, with significant apoptotic cells and the lowest score for neural function at full blood flow. Conclusions (1)CR can effectively increase antiapoptotic gene expression of hippocampus CA region and play an important role in the neural rehabilitation. (2) Low reperfusion flow improves ischemic insults markedly.