目的 探讨重组人促红细胞生成素(rHuEPO )对于蛛网膜下腔出血(SAH)引发的脑血管痉挛的治疗效果与可能机制.方法 将雄性Wistar大鼠70只随机分为SAH组、SAH+ rHuEPO组、SAH+安慰剂组和空白组.采用枕大池二次注血法制作SAH模型.脑血管痉挛的程度以第一次注血后第7天的基底动脉平均横截面积来评估.同时采用酶联免疫吸附法(ELISA)检测血清内皮型一氧化氮合酶(eNOS)及诱导型一氧化氮合酶(iNOS)水平.采用原位细胞凋亡检测法(TUNEL)检测颞叶神经元凋亡情况.结果 枕大池二次注血法成功制作SAH模型,基底动脉发生了明显血管痉挛.应用rHuEPO后脑血管痉挛减轻,可以有效缓解SAH导致的iNOS水平升高及eNOS水平降低,同时抑制细胞凋亡.结论 全身应用rHuEPO,不仅能有效预防大鼠SAH后的脑血管痉挛,还具有神经保护的作用.因此,促红细胞生成素可能成为未来治疗SAH后脑血管痉挛的一个策略,值得进一步研究.%Objective It is to explore the effect and its possible mechanism of rHuEPO on subarachnoid hemorrhage ( SAH ) induced by cerebral vasospasm. Methods Seventy Wistar male rats were randomly divided into the following four groups : SAH group, SAH plus rHuEPO group, SAH plus placebo group, and blank group. Second blood injection method was used to establish SAH models. The degree of vasospasm was determined by averaging the cross sectional areas of the basilar artery in 7 days after the first blood-injection. The levels of serum endothelial nitric oxide synthase ( eNOS ) and inducible nitric oxide synthase ( iNOS ) were determined by enzyme-linked immunosorbent assay( ELISA ). Apoptotic cells were determined by TUNEL staining. Results The SAH models were successfully established by second blood injection method. Obvious cerebral vasospasm was found in basal arteries. Cerebral vasospasm was relieved after using rHuEPO, and it could effectively relieve iNOS increase and eNOS decrease induced by SAH, and inhibit cell apoptosis. Conclusion Systemic administration of rHuEPO not only can prevent cerebral vasospasm following SAH, but also has nervous protection. The role of rHuEPO in the treatment of cerebral vasospasm after SAH is promising and is worthy of further investigation.
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