不同麻醉深度对老龄大鼠术后谵妄的影响及可能机制

发布时间：2018-05-13 00:16

本文选题：麻醉深度 + 老龄大鼠　；参考：《实用医学杂志》2017年01期

【摘要】：目的:观察不同全身麻醉深度对老龄大鼠模型术后谵妄(POD)的影响,并分析其产生的可能机制。方法:120只健康雄性SD大鼠,随机分为静脉组(A组)和吸入组(B组),每组60只,根据BIS值再进一步分为A1、A2、A3、B1、B2、B3 6个亚组,统计实验大鼠POD发生情况、海马神经细胞凋亡率、Bid、Bim、Puma m RNA和蛋白以及Caspase-3 17 k Da表达变化情况。结果:与术前比较,A组3个亚组大鼠的谵妄评分均升高,神经细胞凋亡率升高,Bid、Bim、Puma m RNA和蛋白以及Caspase-3 17 k Da表达升高(P0.05)。与A2组比较,A1组和A3组麻醉后谵妄发生率明显升高,神经细胞凋亡率升高,Bid、Bim、Pumam RNA和蛋白以及Caspase-3 17 k Da表达升高(P0.05)。B组3个亚组上述参数变化与A组相似。A组与B组各亚组间比较差异无统计学意义(P0.05)。结论:维持BIS值60~75/或BIS值30~45麻醉后可增加老龄大鼠POD发生率,其机制可能与增加了线粒体内促凋亡因子Bid、Bim和Puma m RNA和蛋白的表达,增加Caspase-3释放入细胞质,增加海马神经元凋亡相关。
[Abstract]:Aim: to observe the effect of different depth of general anesthesia on postoperative delirium POD in aged rats and analyze its possible mechanism. Methods 120 healthy male Sprague-Dawley rats were randomly divided into intravenous group A (n = 60) and inhaled group B (n = 60). According to the value of BIS, they were further divided into 6 subgroups of A1A1A2A2A3A3OB1B1OB2B3, and the occurrence of POD in experimental rats was statistically analyzed. The apoptotic rate of hippocampal neurons was determined by the changes of Puma m RNA, protein and Caspase-3 17 kDa expression. Results: compared with preoperation, the delirium scores of the three subgroups in group A were all increased, and the apoptosis rate of nerve cells was increased. The expression of Caspase-3 17 kDa and the expression of Caspase-3 17 kDa were increased in BidBiman Puma m RNA and protein. The incidence of delirium in group A 1 and group A 3 was significantly higher than that in group A 2. The increase of neuronal apoptosis rate and the expression of Caspase-3 17 kDa in three subgroups were similar to those in group A. there was no significant difference in the above parameters between group A and group B. there was no significant difference between group A and group B (P 0.05). Conclusion: maintenance of BIS value of 60 ~ 75 / or BIS value of 30 ~ 45 can increase the incidence of POD in aged rats after anesthesia. The mechanism may be related to the increase of the expression of Bidbim, Puma m RNA and protein in mitochondria, and the release of Caspase-3 into cytoplasm. Increased apoptosis of hippocampal neurons was associated with increased apoptosis.
【作者单位】：天津医科大学总医院滨海医院麻醉科;天津医科大学总医院麻醉科;
【分类号】：R614

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