摘要
目的探讨不同时间迷走神经电刺激(vagus nerve stimulation,VNS)对心脏骤停(cardiac arrest,CA)/心肺复苏(cardiopulmonary resuscitation,CPR)后大鼠预后的影响。方法采用改良经皮心外膜电刺激诱导心室颤动方法建立大鼠CA模型。53只雄性SD大鼠随机(随机数字法)分成假手术组(SHAM,n=5)、CPR组(n=12)和VNS组(n=36)。SHAM组不经历CA/CPR;VNS治疗分别设置在CA前30 min(PRE组,n=12)、自主循环恢复(recovery of spontaneous circulation,ROSC)后5 min(POST5组,n=12)以及ROSC后30 min(POST30组,n=12),以统一的刺激参数给予迷走神经电刺激30 min。观察大鼠ROSC后24、48、72 h的神经功能缺损评分和72 h生存率。采用TUNEL染色检测ROSC后72 h的大鼠脑组织皮质区细胞凋亡情况,采用免疫荧光检测α7烟碱型乙酰胆碱受体(α7 subunit-containing nicotinic acetylcholine receptor,α7nAChR)的表达。计量资料组间比较采用单因素方差分析,生存率采用Kaplan-Meier分析和Log-rank检验。以P<0.05为差异有统计学意义。结果与CPR组(生存率为33.33%)相比,CA前VNS处理(PRE,生存率为75%)和CA后VNS处理(POST5组生存率75%;POST30组生存率83.33%)均可显著提高大鼠CPR后72 h生存率(P<0.05),降低ROSC后的神经功能缺损评分,降低脑皮质细胞凋亡阳性率,而VNS各处理组间差异无统计学意义(P>0.05)。VNS处理后脑皮质α7nAChR的表达较CPR组增加。结论CA前和ROSC后5 min和30 min给予VNS处理均对CA/CPR大鼠具有脑保护的作用,其机制可能与激活α7nAChR介导的抗炎与抗凋亡效应有关。
Objective To explore the protective effect of vagus nerve stimulation(VNS)on the prognosis of rats suffering from cardiac arrest/cardiopulmonary resuscitation(CA/CPR)under different treatment timings.Methods The method of percutaneous epicardial electrical stimulation was used to establish CA model of rat.Fifty-three male SD rats were randomly(random number)divided into the sham group(n=5),CPR group(n=12),PRE group(n=12),POST5 group(n=12)and POST30 group(n=12).The sham group did not experience CA/CPR.VNS treatment was started at 30 min before CA(PRE group,n=12),5 min after recovery of spontaneous circulation(ROSC)(POST5 group,n=12),and 30 min after ROSC(POST30 group,n=12)in different VNS-treated group,respectively.The electrical stimulation was applied to the vagus nerve for 30 min with a unified parameter.The neurological deficit scores at 24,48,and 72 h after ROSC were recorded,and the survival rate in each group was observed.TUNEL staining was used to detect the apoptosis of cortical area and the expression ofα7 nicotinic acetylcholine receptor(α7nAChR)in brain tissue was measured by immunofluorescence at 72 h after ROSC.Variables were compared with one-way analysis of variance,and survival for Kaplan-Meier curves were tested with the log-rank test.A P value less than 0.05 was considered statistically significant.Results Compared with the CPR group(survival rate 33.33%),both pre-treatment(survival rate 75%)and post-treatment of VNS(POST5 group survival rate 75%and POST30 group survival rate 83.33%)significantly improved the 72 h survival rate after CPR(P<0.05),mitigated neurological deficits after ROSC,reduced the positive rate of apoptosis neurons,and up-regulated the expression ofα7nAChR in cerebral cortex.There was no significant difference among the VNS-treated groups(all P>0.05).Conclusions Both pre-treatment and post-treatment of VNS can play a protective role in rats after CA/CPR,which may be related to the activation ofα7nAChR-mediated anti-inflammatory and anti-apoptosis effects。
作者
邵伟婧
许双
黄鹤
舒婷婷
张瑜涵
梁利彩
周榆然
孙鹏
Shao Weijing;Xu Shuang;Huang He;Shu Tingting;Zhang Yuhan;Liang Licai;Zhou Yuran;Sun Peng(Department of Emergency Medicine,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430022,China;Department of Emergency Medicine,Hankou Branch of Central Theater General Hospital,Wuhan 430070,China;Department of Intensive Care Unit,Wuhan Hospital of Traditional Chinese Medicine,Wuhan 430000,China;Department of Emergency Medicine,Xiangyang Central Hospital,Xiangyang 441021,China;Department of Emergency Medicine,Second Affiliated Hospital,Zhejiang University School of Medicine,Hangzhou 310009,China)
出处
《中华急诊医学杂志》
CAS
CSCD
北大核心
2021年第1期31-36,共6页
Chinese Journal of Emergency Medicine
基金
国家自然科学基金(81571866)。
