维生素C对脓毒症大鼠脑损伤的改善作用

被引：7

作者：

吕娟娟

陈志江

陈剑锋

黄锦达

张炬兴

王斌

陶少华

王阳

吴渚

金明

曾其毅

机构：

[1] 广州,南方医科大学珠江医院儿科

来源：

中华实用儿科临床杂志 | 2018年 / 33卷 / 18期

基金：

广东省科技计划;

关键词：

脓毒症; 脑损伤; 维生素C; 氧化应激;

D O I：

暂无

中图分类号：

R459.7 [急症、急救处理];

学科分类号：

100231 [临床病理学];

摘要：

目的探讨维生素C对脓毒症大鼠脑损伤的改善作用。方法将SPF级雄性SD大鼠按随机数字表法分为对照组、假手术组、脓毒症组、脓毒症治疗组。脓毒症组通过阑尾结扎穿孔术建立脓毒症模型。脓毒症治疗组在造模后3 h通过尾静脉注射维生素C, 其余组大鼠予等量9 g/L盐水。分别在相应时间点进行神经反射评估后断头取脑。提取脑组织蛋白, 按照检测试剂盒说明书测定活性氧(ROS)、超氧化物歧化酶(SOD)、丙二醛(MDA) 、一氧化氮(NO)、诱导型一氧化氮合成酶(iNOS)和过氧化氢酶(CAT)。采用苏木精-伊红(HE)染色观察脑组织病理学变化。结果脓毒症组(7 d生存率为30%)较对照组(7 d生存率为100%)及假手术组(7 d生存率为100%)生存率明显下降, 脓毒症治疗组(7 d生存率为45%)较脓毒症组生存率明显升高, 差异均有统计学意义(均P<0.05)。神经反射评分在脓毒症组6 h开始下降, 24 h达到最低(6.00±0.53), 脓毒症治疗组较脓毒症组评分明显升高(7.62±0.52), 72 h开始逐渐恢复(8.63±0.52), 与脓毒症组比较, 差异有统计学意义(P<0.05)。ROS、SOD、MDA、NO、iNOS在脓毒症组和脓毒症治疗组24 h均达高峰, 72 h已经下降, 脓毒症治疗组较脓毒症组均有显著下降, 差异有统计学意义(P<0.05);CAT的变化与之相反。SOD/CAT在脓毒症组24 h最高, 脓毒症治疗组则有明显改善, SOD/CAT与MDA呈强正相关(r=0.968, P<0.05);HE染色可见脓毒症组脑组织结构明显破坏, 脓毒症治疗组较脓毒症组有明显改善。结论在SD大鼠脓毒症模型中, 静脉给予维生素C可明显改善生存率及脑病症状, 其机制可能与减少氧化应激有关。

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