血塞通联合右美托咪定对老龄大鼠脑缺血再灌注损伤的保护效果研究

doi:10.20223/j.cnki.1000-8535.2025.07.009

摘要/Abstract

摘要： 目的评价血塞通联合右美托咪定对脑缺血再灌注损伤大鼠的脑保护效果。方法选择老龄雄性Wistar大鼠50只,随机分为假手术（C）组、脑缺血再灌注（R）组、血塞通（P）组、右美托咪定（D）组,血塞通联合右美托咪定（PD）组,每组各10只。根据组别给予不同药物,行神经行为学测试;于第3、7天,测量脑梗死面积、脑水含量,以及超氧化物歧化酶（SOD）、谷胱甘肽过氧化酶（GSH-PX）活性测定。结果给药后第3、5、7天,与P、D组相比,PD组神经行为学评分改善更加显著（P<0.001）;给药后第3、7天,与P组相比,PD组脑梗死面积、脑水含量均降低（P=0.01,P=0.002）,SOD、GSH-PX活性升高显著（P=0.03,P=0.001）;与D组相比,PD组脑梗死面积、脑水含量也显著降低（P<0.01,P=0.008）;SOD、GSH-PX活性升高显著（P=0.009,P<0.001）。结论血塞通联合右美托咪定较单独应用药物,能显著减轻缺血再灌注损伤造成的脑损害,具有脑保护作用。

关键词: 血塞通, 右美托咪定, 缺血再灌注, 脑卒中, 大鼠

Abstract: Objective To explore the effects of Xuesaitong combined with dexmedetomidine on cerebral ischemia-reperfusion in elderly rats．Methods Fifty elderly male Wistar rats were randomly divided into 5 groups：sham operation（C）group,cerebral ischemia-reperfusion（R）group,Xuesaitong（P）group,dexmedetomidine（D）group,Xuesaitong combined with dexmedetomidine（PD）group．Xuesaitong was given in group P,dexmedetomidine was given in group D,and normal saline was given in group C and group R,continuously for 7 days．After 3- and 7-day treatment,the brain of rats was dissected out to assay the area of cerebral infarction,degree of cerebral edema,superoxide dismutase（SOD） and glutathione peroxidase（GSH-PX） activity．Results When compared PD group with P and D group,neurobehavioral score was lower at 3,5,7 day（P<0.001）;area of cerebral infarction,degree of cerebral edema were less（P=0.01,P=0.002）,activity of SOD and GSH-PX were higher at 3,7 days（P=0.03,P=0.001）respectively．When compared PD group with D group,area of cerebral infarction,degree of cerebral edema were less（P<0.01,P=0.008）,activity of SOD and GSH-PX were higher at 3,7 days（P=0.009,P<0.001）respectively．Conclusions The combination of Xuesaitong and dexmedetomidine can obviously reduce the damage by cerebral ischemia-reperfusion in elderly rats and has brain protective effects．

Key words: Xuesaitong, dexmedetomidine, ischemia-reperfusion, stroke, rat

李金泽, 万晓燕, 王秀芹. 血塞通联合右美托咪定对老龄大鼠脑缺血再灌注损伤的保护效果研究[J]. 广州医药, 2025, 56(7): 918-923.

LI Jinze, WAN Xiaoyan, WANG Xiuqin. Effects of Xuesaitong combined with dexmedetomidine on cerebral ischemia-reperfusion injury in elderly rats[J]. Guangzhou Medical Journal, 2025, 56(7): 918-923.

参考文献

[1] 《中国脑卒中防治报告2018》编写组.我国脑卒中防治仍面临巨大挑战:《中国脑卒中防治报告2018》概要[J].中国循环杂志,2019,34(2):105-119.
[2] BOEHME A K,ESENWA C,ELKIND M S.Stroke risk factors,genetics,and prevention[J].Circ Res,2017,120(3):472-495.
[3] LAPCHAK P A,ZHANG J H.The high cost of stroke and stroke cytoprotection research[J].Trans Stroke Res,2017,8(4):307-317.
[4] 任亚丽,买雷.银杏二萜内酯葡胺注射液联合依达拉奉右崁醇对急性缺血性脑卒中患者的疗效分析[J].广州医药,2023,54(6):68-73.
[5] 胡一凡. 复方脑肽节苷脂注射液联合阿替普酶静脉溶栓治疗急性缺血性脑卒中的安全性及疗效分析[J].广州医药,2024,55(3):306-310.
[6] 刘跃辉,徐晓娅,邓慧远,等.血塞通联合阿托伐他汀治疗老年缺血性脑卒中临床研究[J].中国药业,2021,30(8):61-63.
[7] 刘伟,王钦鹏,李晓玲.血塞通联合盐酸文拉法辛治疗短暂性脑缺血发作和轻型卒中患者躯体化症状的临床研究[J].国际老年医学杂志,2021,42(2):71-72.
[8] 何小庆,章鹏,李小玉,等.丁苯酞联合血塞通治疗急性缺血性脑卒中的临床效果[J].黑龙江医学,2023,47(5):551-553.
[9] 叶荣洲,吴海云,杨志燕,等.茴拉西坦配合血塞通对老年急性脑梗死患者脑血流及血清TLR4/NF-κB信号通路的影响[J].中国老年医学杂志,2022,42(15):3649-3653.
[10] 陈大鹏,陈桂雨.血塞通联合依达拉奉右莰醇注射液对急性脑梗死患者神经功能及氧化应激指标的影响[J].罕少疾病杂志,2023,30(10):11-12.
[11] LIU B,LIANG Y,HUANG W,et al.Dexmedetomidine attenuates spinal cord ischemia-reperfusion injury in rabbits by decreasing oxidation and apoptosis[J].Curr Mol Med,2023,23(6):569-577.
[12] 刘洋,胡金玲.右美托咪啶对大鼠脑保护作用及其机制的研究进展[J].广东化工,2022,49(5):66-67.
[13] 汪鸿,殷俊茹,牛晶.右美托咪啶对重症颅脑外伤患者躁动镇静的临床效果及手术麻醉中的脑保护作用观察[J].贵州医药,2022,46(11):1685-1687.
[14] 林军,李艳芳,李冲,等.线栓法大鼠MCAO模型制作的要点及经验总结[J].医学综述,2018,24(17):3398-3402,3408.
[15] 邢亚明. 血塞通胶囊对缺血性脑卒中大鼠脑组织氧化应激损伤的预防作用[J].武警后勤学院学报(医学版),2018,27(10):815-819.
[16] 艾升,李学军.血塞通汤剂对全脑缺血再灌注氧化应激作用的影响[J].西部中医药,2018,31(12):69-71.
[17] 王萍,闫东明,黄茜,等.三七总皂苷治疗缺血性脑卒中的神经保护机制[J].中国药理学通报,2018,34(12):1750-1755.
[18] 高举,张清学,崔涛等.血塞通注射液联合复方脑肽节苷脂治疗急性脑梗死的临床研究[J].现代药物与临床,2023,38(11):2727-2741.
[19] 李东建,崔宏彬.重组人促红细胞生成素联合阿司匹林血塞通注射液治疗急性缺血性脑梗死疗效观察[J].中国药物与临床,2021,21(24):4033-4035.
[20] YANG X,WU J,CHENG H,et al.Dexmedetomidine ameliorates acute brain injury induced by myocardial ischemia-reperfusion via upregulating the HIF-1 pathway[J].Shock,2023,60(5):678-687.
[21] SUN Z,ZHAO T,LV S,et al.Dexmedetomidine attenuates spinal cord ischemia-reperfusion injury through both anti-inflammation and anti-apoptosis mechanisms in rabbits[J].J Transl Med,2018,16(1):209.
[22] 陈思,董利萍,张玥,等.AMP活化蛋白激酶信号通路:缺血性卒中的潜在治疗靶点[J].国际脑血管病杂志,2022,30(6):448-454.
[23] 周宇,李斌,马勇,等.环状RNA在调控脑缺血再灌注损伤中的作用研究进展[J].中华神经医学杂志,2023,22(5):523-528.
[24] YIN M J,LIU Z Y,WANG J,et al.Buyang Huanwu Decoction alleviates oxidative injury of cerebral ischemia-reperfusion through PKCƐ/Nrf2 signaling pathway[J].J Ethnopharmacol,2023(303):11593.
[25] BAI L L,ZHANG L Q,MA J,et al.DIP2A is involved in SOD-mediated antioxidative reactions in murine brain[J].Free Radic Biol Med,2021(168):6-15.
[26] 王亚楠,刘佳,张林,等.Keap1/Nrf2/ARE信号通路调控线粒体分裂在脑缺血/再灌注损伤中的作用[J].国际麻醉学与复苏杂志,2020,41(4):321-325.
[27] 刘瑞,司少魁.Nrf2/ARE信号通路对呼吸系统的影响研究[J].国际呼吸杂志,2021,41(18):1415-1419.
[28] 于露,罗杰斯,任毅,等.肌肽通过激活Nrf2/ARE信号通路改善OGD/R诱导星形胶质细胞损伤[J].中国临床解剖学杂志,2023,41(3):310-317.