摘要目的 探讨心肺复苏后大鼠海马神经元磷脂酰肌醇-3-激酶(phosphoinositide 3-kinase,PI3K)、蛋白激酶B(protein kinase B,PKB)、磷酸化cAMP应答元件结合蛋白(phosphorylation of cAMP respouse element binding protein,p-CREB)表达的变化,以及APP17肽对它们的影响.方法 实验地点在宣武医院神经变性病学重点实验室.雄性Wistar大鼠21只,随机分3组,每组7只:假手术对照组(A组)、心肺复苏组(B组)、心肺复苏+APP17肽组(C组).自主呼吸循环恢复(return of spontaneous circulation,ROSC)标准为心电图出现正常的QRS波群,心室内压≥60 mmHg,持续10 min以上;夹闭气管制作大鼠心跳呼吸停止模型,行心肺复苏.当大鼠出现ROSC时,复苏组静脉注射生理盐水;APP17肽组静脉注射APP17肽10μg·(300 g)~(-1).对照组行假手术,静脉注射生理盐水.维持生命体征至2 h,断头取脑,行冰冻切片.应用免疫组化法观察3组大鼠复苏2 h后海马神经元PI3K,PKB,p-CREB表达情况;三组中各取1只大鼠于ROSC后2 h,分离海马;应用Western-blot方法测定海马神经元PKB,p-CREB蛋白含量.数据以均数±标准差((x)±s)表示,组间数据用方差分析,以P<0.05为差异具有统计学意义.结果 免疫组化法显示:B组PI3K阳性细胞表达为(2.75±1.80),略高于A组(2.53±1.53),差异没有统计学意义;而C组为(5.85±2.83),较B组增加,差异具有统计学意义(P<0.01).B组PKB和p-CREB阳性细胞分别较A组明显减少[(2.45±1.36)vs.(5.22±2.50),(P<0.05);(2.41±1.11)vs.(8.31±3.02),P<0.01];C组PKB和p-CREB阳性细胞分别较B组增高[(9.66±4.32)vs.(2.45±1.36),P<0.01;(14.18±3.96)vs.(2.41±1.11),P<0.01].Western-blot法测定PKB,p-CREB蛋白含量B组较A组明显减少;C组较B组明显增加.结论 心肺复苏大鼠ROSC 2 h海马神经元PKB,p-CREB表达降低,APP17肽能恢复神经元PI3K,PKB,p-CREB的表达,对心肺复苏后海马神经元损伤有保护作用.

abstractsObjective To explore the effects of beta-amyloid precursor protein (APP17) peptide on the changes in the expressions of phosphoinositide 3-kinase(PI3K), protein kinase B(PKB) and phosphorylation of cAMP response element binding protein (p-CREB) in the neurons of hippocampal gyms in rats after cardiopulmonary resuscitation. Method Twenty-one Wistar rats were randomly divided into three groups, namely the sham-operated control group, the resuscitation group and resuscitation with APP17 peptide-treated group. The rat model of asphyxial cardiac arrest was made by clamping the endotracheal tube and the standard external cardiopulmonary resuscitation ( CPR) was performed until the restoration of spontaneous circulation ( ROSC) observed.ROSC was defined by the appearance of normal QRS waves of electrocardiogram and mean artery pressure ( MAP)≥60 mmHg for more than 10 minutes. Rats of resuscitation group and control group received intravenous 0.9%NaCl, and the rats of the APP17 peptide group were treated with APP17 peptide(10μg·300 g~(-1), i. v.) after ROSC. Rats were sacrificed by decapitation after reperfusion 2 hours and then the cerebral hippocampal gyrus was immediately separated to detect PI3K, PKB and p-CREB by immunohistochemistry ( IHC) and Western-blot analysis. Statistical comparisons were made by one-way analysis of variance (ANOVA) . Results IHC showed that there was no significant difference in PDK positive cells between resuscitation group and control group (2.75 ±1.80 vs. 2.53 ± 1.53, P > 0.05) . The PDK obviously more increased in the APP17 peptide group than in resuscitation group(5.85 ± 2.83 vs. 2.75 ± 1.80, P < 0.01) .The counts of PKB and p-CREB positive cells were obviously lower in resuscitation group than those in control group (2.45 ± 1.36 vs. 5.22 ± 2.50, P < 0.05);(2.41 ± 1.11 vs. 8.31 ±3.02, P < 0.01 ). The PKB and p-CREB positive cells were significantly higher in the APP17 peptide group than in resuscitation group (9.66±4.32 vs. 2.45 ±1.36, P < 0.01);(14.18 ± 3.96 vs.2.41 ± 1.11, P <0.01). The PKB and p-CREB protein levels in resuscitation group were lower than those in the control group. Conclusions The expressions of PKB and p-CREB in neurons of hippocampus gyrus 2 hours ROSC, and APP17 peptide could restorer the expression of PDK, PKB and p- CREB and thereby protect the neurons of hippocampus gyrus from the injury of CPR.