[1]苏长生　王丽萍　陈国忠　杨建藤　林文谦.上胸段硬膜外应用罗哌卡因纳米微粒对兔迟发型脑血管痉挛的作用[J].中国临床神经外科杂志,2016,(09):540-544.[doi:10.13798/j.issn.1009-153X.2016.09.010]
　SU Chang-sheng,WANG Li-ping,CHEN Guo-zhong,et al.Effect of ropivacaine discharged from nanoparticles in upper thoracic epidural space on delayed cerebral vasospasm in rabbits with SAH[J].,2016,(09):540-544.[doi:10.13798/j.issn.1009-153X.2016.09.010]
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上胸段硬膜外应用罗哌卡因纳米微粒对兔迟发型脑血管痉挛的作用()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2016年09期
页码:
540-544
栏目:
论著
出版日期:
2016-09-25

文章信息/Info

Title:
Effect of ropivacaine discharged from nanoparticles in upper thoracic epidural space on delayed cerebral vasospasm in rabbits with SAH
文章编号:
1009-153X（2016）09-0540-05
作者:
苏长生　王丽萍　陈国忠　杨建藤　林文谦
350025 福州，南京军区福州总医院麻醉科
Author(s):
SU Chang-sheng;  WANG Li-ping;  CHEN Guo-zhong;  YANG Jian-teng;  LIN Wen-qian
Department of Anesthesiology, Fuzhou General Hospital, Nanjing Command, PLA, Fuzhou 350025, China
关键词:
蛛网膜下腔出血; 迟发型脑血管痉挛; 上胸段硬膜外腔阻滞; 罗哌卡因; 纳米药物; 兔
Keywords:
Subarachnoid hemorrhage;  Delayed cerebral vasospasm;  Upper thoracic epidural space;  Ropivacaine;  Nanoparticles
分类号:
R 743.9
DOI:
10.13798/j.issn.1009-153X.2016.09.010
文献标志码:
A
摘要:
目的 探讨上胸段硬膜外应用罗哌卡因纳米微粒对兔蛛网膜下腔出血（SAH）后迟发型脑血管痉挛（DCVS）的影响。方法 将上胸段硬膜外置管成功的新西兰兔75只随机均分为5组（n=15）：假手术组、SAH组、纳米粒空载体组、纳米粒载药组和泵注药物组；各组再分为造模后l、7、14 d三个亚组（n=5）。采用枕大池二次注血法制作SAH模型，二次注血后30 min，纳米粒空载体组经硬膜外导管注射等体积纳米微粒空载体，纳米粒载药组注射罗哌卡因纳米微粒（60 mg/kg；含罗哌卡因8 mg/kg），泵注药物组经硬膜外导管接镇痛泵持续泵入0.1%罗呱卡因（1 ml/h）。采用Yamaguchi评分评估神经功能，采用经颅多普勒超声检测基底动脉平均血流速度（Vm）和收缩期峰值血流速度（Vp），ELISA法检测血清神经元特异性烯醇化酶（NSE）、S100B水平，HE染色光镜下观察基底动脉（BA）形态并测量其管径，免疫组化染色观察BA内皮细胞内皮型一氧化氮合酶（eNOS）与内皮素（ET-1）表达。结果 造模后1、7、14 d，与假手术组相比，SAH组兔神经功能评分均明显增高（P<0.05），BA Vm和Vp均明显增高（P<0.05），血清NSE和S100B水平均明显增高（P<0.05），BA管径均明显缩小（P<0.05），BA内皮细胞eNOS表达水平明显降低（P<0.05），BA内皮细胞ET-1表达水平明显增高（P<0.05）；SAH组与纳米粒空载体组上述指标均无明显差异（P>0.05）；与SAH组相比，泵注药物组Vm和Vp显著降低（P<0.05），神经功能显著改善（P<0.05），血清NSE和S100B水平和BA内皮细胞ET-1表达水平显著降低（P<0.05），BA内皮细胞eNOS表达水平显著增高（P<0.05）；纳米粒载药组与泵注药物组无明显差异（P>0.05）。结论 上胸段硬膜外泵注罗哌卡因能改善兔SAH后DCVS，而硬膜外应用罗哌卡因纳米微粒能够获得同样的效果。
Abstract:
Objective To investigate the effect of ropivacaine discharged from nanoparticles in the upper thoracic epidural on delayed cerebral vasospasm (DCVS) in rabbits after subarachnoid hemorrhage (SAH). Methods The upper thoracic epidural catheter were successfully placed in 75 healthy New Zealand rabbits which were randomly divided into five groups of 15 rabbits each, i.e. sham-operation group, control group, placebo nanoparticles group, ropivacaine-loaded nanoparticles group and pumping ropivacaine group. The models of SAH were established by two injections of autoblood into the cistern magnas. Neurobehavioral score was determined after SAH. Transcranial Doppler ultrasonography was used to detect the basilar artery (BA) mean flow velocity (Vm) and peak systolic blood flow velocity (Vp). The serum levels of neuron specific enolase (NSE) and S100B protein were measured by ELISA method. Morphological changes were observed under light microscope and tube diameters of BA were measured. The expressions of endothelin-1 (ET-1) and endothelial nitric oxide synthase (eNOS) were measured by immunohistochemical technique in the endothelial cells of BA. Results The neurobehavioral score, degree of BA stenosis, Vm and Vp, level of ET-1 expression in the endothelial cells of BA and serum levels of NSE and S100B protein were significantly lower and the level of eNOS expression was significantly higher in ropivacaine-loaded nanoparticles group than placebo nanoparticles and control groups (P<0.01). Conclusion DCVS after SAH can be alleviated by ropivacaine discharged from nanoparticles in upper thoracic epidural space in the rabbits.

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备注/Memo

备注/Memo:
基金项目：福建省科技计划资助项目（2012Y0054）
通讯作者：陈国忠，E-mail：cgzssq2000@sina.com
更新日期/Last Update: 2016-09-30