摘要目的 从线粒体功能方面探讨急性等容性血液稀释(acute normovolemic hemodilution,ANH)对全脑缺血/再灌注(ischemia/reperfusion,I/R)损伤大鼠的保护作用.方法 24只雄性清洁SD大鼠,按随机数字表法随机分为4组:假手术组(SHAM组),I/R组,血液稀释至红细胞压积(hematocrit,Hct)30％后I/R组(HES30组),血液稀释至Hct40％后I/R组(HES40组),每组6只.采用四血管法建立大鼠全脑I/R模型.夹闭双侧颈总动脉前0.5 h,从股静脉抽取血液,同时输注等量6％羟乙基淀粉130/0.4氯化钠溶液(hydroxyethyl starch 130/0.4 and sodium chloride injection,HES)行ANH.48 h后处死大鼠,取大脑海马组织,分光光度仪测定细胞色素c氧化酶(cytochrome c oxidase,CcO)活性,逆转录聚合酶链式反应法(reverse transcriptionpolymerase chain reaction,RT-PCR)测定CcO亚基Ⅱ(CcOⅡ)mRSA表达情况.结果 I/R组CcO活性和CcOⅡmRNA表达分别为(0.021±0.012)和(0.079±0.009) (P＜0.01),与SHAM组比较分别降低至约7.580％和20.570％；HES40组CcO活性和CcOⅡmRNA表达分别为(0.120±0.032)和(0.180±0.033)(P＜0.01),与SHAM组比较,分别降低至约43.320％和46.870％；HES30组CcO活性和CcOⅡmRNA表达分别为(0.180±0.026)和(0.347±0.027)(P＜0.01),与SHAM组比较,分别降低至约64.980％和90.360％,与HES40组比较,下降程度较低(P＜0.01).结论 应用6％HES130/0.4 ANH处理全脑I/R能升高线粒体内膜蛋白CcO活性及表达,且在Hct30％时达到最佳效果.适当的ANH处理促进线粒体功能和供能状态改善,具有脑保护作用.

abstractsObjective This study was designed to discuss the influence of the acute normovolemic hemodilution (ANH) in global cerebral ischemia/reperfusion (I/R) injury in terms of mitochondrial inner membrane.Methods 24 healthy male SD rats were randomly divided into 4 groups(each one 6 rats):sham group(SHAM),I/R group,ANH Hct30％ and I/R group(HES30),ANH Hct40％ and I/R group (HES40).Ischmia was established by four-vessel cerebral I/R model.Half an hour before bilateral carotid arteries were blocked,blood was drawn from the femoral vein,and in the meantime,the same amount of 6％ hydroxyethyl starch (HES) solotion (130/0.4) was transfused.After 48 h,the rats were executed and hippocampus was taken out.The activity of cytochrome c oxidase(CcO) were measured by spectro photometry instrument,and the expression of CcO Ⅱ mRNA were determianted by RT-PCR method.Results Compared with the SHAM group,the CcO activity and CcO Ⅱ mRNA expression of I/R group were reduced to about 7.58％ and 20.57％(0.0210x±0.012 and 0.079±0.009,P＜0.01).In HES40 group,they were reduced to about 43.32％and 46.87％(0.120±0.032 and 0.180±0.033,P＜0.01),compared with the SHAM group.In HES30 group they were reduced to about 64.980％ and 90.360％(0.180±0.026 and 0.347±0.027,P＜0.01) compared with the SHAM group and decreased less than HES40 group.Conclusions Application of 6％HES130/0.4 treatment of ANH can improve activity and expression of CcO in hippocampus mitochondria after cerebral I/R.Its protection achieves the optimal outcome when hemodiluted to Hct30％.The appropriate acute hemodilution elevates themitochondrial function and energy supply,improving the outcome of the global cerebral I/R.