纳洛酮对心肺复苏犬脑组织病理及S100蛋白表达的影响

目的:检测心肺复苏后6 h犬脑组织病理及S100蛋白、S100B蛋白mRNA表达的变化,以探讨纳洛酮对脑复苏的影响.方法:18只健康杂种犬,随机分成3组,每组6只,予体外电击诱发室颤,对照组:心跳骤停后予标准心肺复苏术;纳洛酮组:心跳骤停后予标准心肺复苏术 纳洛酮;空白组:不诱发室颤,于复苏后6 h取脑海马组织行脑形态学检查及S100蛋白和S100B蛋白mRNA表达的测定.结果:纳洛酮组S100阳性细胞数明显少于对照组(P＜0.01),多于空白组.S100B蛋白mRNA表达在空白组、对照组、纳洛酮组分别为0.028±0.019,0.367±0.015,0.130±0.018,其中空白组和对照组的S100B蛋白mRNA表达均明显低于对照组(P＜0.01).对照组病理变化明显,可见神经元脱失、神经元胞浆浓缩、核仁不清、毛细血管明显肿胀变形等.而纳洛酮组相同部位的神经元脱失和损伤轻于对照组,仅少数神经细胞和毛细血管出现程度不等的水肿样改变及胞核固缩现象.结论:使用纳洛酮后心肺复苏犬脑组织的病理损害有所减轻,纳洛酮可能与降低心跳骤停后脑组织S100B蛋白mRNA表达因而使S100蛋白的生成减少相关.

Effects of Naloxone on the Expression of Protein S100 and Pathologic Changes in the Cerebral Tissue of Post-resuscitation Dogs from Cardiac Arrest

Objective:To determine the expression of S100,S100B mRNA and the pathological change of canine cerebral tissue at 6 hours after CPR,and the effects of naloxone on CPR.Methods: 18 healthy adult hybrid dogs were randomly divided into blank group,control group and naloxone group(n=6 per group).The control group received standard CPR after induced ventricular fibrillation;the naloxone group received additional use of naloxone,while the blank group was not given any treatment.The three groups were collected for hippocampus tissues at 6 hours post-CPR to be detected for S100B concentration and pathological change. Results: The number of S100-positive cells in the naloxone group was significantly lower than that in the control group but higher than that in the blank group(P<0.01).The control group exhibited obvious pathological lesion of nerve cells including neuron loss,concentrated neuronal cytoplasma,ill-demarcated nucleolus and edematous capillaries,compared with the milder changes of neurons in the naloxone group.Conclusion: Naloxone may ameliorate post-CPR cerebral lesion in dogs,likely by associated with the decreased production of cerebral S100 after cardiopulmonary resuscitation.