本文選題：腦缺血 + 大腦中動脈阻塞　； 參考：《新鄉(xiāng)醫(yī)學院》2017年碩士論文

【摘要】：背景腦卒中以其高發(fā)病率、高致死率、高復發(fā)率的特點,目前是中國居民的第一位死因,給社會及家庭造成了嚴重的負擔。而急性缺血性腦卒中(即腦梗死)是最常見的腦卒中類型,約占全部腦卒中的60%~80%,加強針對其病因、發(fā)病機制、預防及治療的研究,可以為減少其發(fā)病率、降低其不良預后率提供更多可選擇的途徑。而可重復的、對缺血性卒中病理過程有較好模擬性的動物模型是進行相關缺血性腦損傷研究的一個至關重要的因素。線栓法制備的大鼠大腦中動脈閉塞模型是目前應用最多的一種急性局灶性腦缺血模型,其建模方法、梗死體積、神經(jīng)功能缺失均較穩(wěn)定,但因缺乏相對客觀、便捷的評價手段,仍有一定的建模失敗率。激光多普勒腦血流監(jiān)測可以準確的反應建模期間腦皮質(zhì)血液灌注的變化程度和持續(xù)時間。目的探討激光多普勒腦血流監(jiān)測在以線栓法制備大鼠大腦中動脈閉塞模型時的評價作用,為模型制備的評價提供更加客觀的標準。方法分別將線栓插入30只SPF級Wistar Han大鼠頸內(nèi)動脈顱內(nèi)段(16.0±0.5)、(18.0±0.5)和(20.0±0.5)mm,制備3種局灶性腦缺血模型(各10只)。缺血及再灌注后6 h對所有實驗大鼠進行Longa神經(jīng)行為學評分,然后依據(jù)顱底有無血凝塊及2,3,5氯化三苯基四氮染色后大腦中動脈供血區(qū)有無梗死灶將其分為不全阻塞組、完全阻塞組及過深阻塞組3組,對阻塞頸內(nèi)動脈顱內(nèi)段前后及拔出線栓再灌注后每只大鼠大腦中動脈供血區(qū)腦皮質(zhì)的血流量以激光多普勒法進行監(jiān)測記錄并進行統(tǒng)計學分析。大腦中動脈供血區(qū)腦皮質(zhì)的血流量以相對流量單位PU值表示;阻塞后及再灌注后的腦皮質(zhì)血流量變化以與阻塞前腦皮質(zhì)血流量的百分比表示。結果模型制作過程中,1只大鼠死亡;納入不全阻塞組9只,完全阻塞組15只,過深阻塞組5只。不全阻塞組線栓插入深度在(16.0±0.5)mm的大鼠有8只,不能完全阻止大腦前動脈向大腦中動脈的血流,缺血6 h后大鼠Longa評分0~1分;顱底動脈環(huán)周圍無血凝塊,經(jīng)TTC染色后無梗死灶。完全阻塞組線栓插入深度在(18.0±0.5)mm的大鼠有9只,大腦前動脈的血流被完全阻斷,缺血6 h后大鼠存在明顯的神經(jīng)功能缺失,Longa評分2~3分;顱底動脈環(huán)周圍無血凝塊而TTC染色提示存在大腦中動脈供血區(qū)的梗死灶。過深阻塞組線栓插入深度在(20.0±0.5)mm的大鼠有5只,可完全阻斷大腦前動脈的血流,缺血6 h后大鼠神經(jīng)功能存在嚴重缺失,Longa評分3~4分;解剖可見顱底血凝塊,TTC染色后可見中動脈供血區(qū)梗死灶。插入線栓后,不全阻塞組、完全阻塞組和過深阻塞組大鼠腦皮質(zhì)血流量均較阻塞前下降(分別為94±17比256±36、43±9比286±44、44±6比294±46,均P0.05),組間差異有統(tǒng)計學意義(F=56.57,P0.01),完全阻塞組和過深阻塞組血流量明顯低于不全阻塞組(均P0.05),完全阻塞組與過深阻塞組間差異無統(tǒng)計學意義(P0.05);3組與阻塞前腦皮質(zhì)血流量的百分比分別為(36.93±0.06)%、(15.09±0.02)%、(15.52±0.04)%,組間差異有統(tǒng)計學意義(F=39.14,P0.01)。再灌注后,不全阻塞組、完全阻塞組和過深阻塞組腦皮質(zhì)血流量(分別為213±31、147±17、96±14)均較阻塞后有明顯回升(均P0.05),組間差異有統(tǒng)計學意義(F=50.05,P0.01),過深阻塞組腦皮質(zhì)血流量明顯低于完全阻塞組(P0.05);3組與阻塞前腦血流量水平百分比分別為(83.10±0.02)%、(51.83±0.05)%、(33.49±0.09)%,差異有統(tǒng)計學意義(F=93.23,P0.01)。以激光多普勒監(jiān)測的腦皮質(zhì)血流量變化作為MCAO缺血模型制備成功的判斷標準,其靈敏度和特異度要高于神經(jīng)行為學評分(93.33 vs 80.00,92.86 vs78.57)。結論以激光多普勒對腦血流進行監(jiān)測,可作為判斷線栓法制備大鼠MCAO腦缺血模型成功的一種實時、便捷、微創(chuàng)、客觀可靠的評價標準,其靈敏度和特異度均高于神經(jīng)行為學評分。
[Abstract]:Background cerebral apoplexy, with its high incidence, high mortality and high recurrence rate, is the first cause of death in Chinese residents, causing serious burden to society and family. Acute ischemic stroke (cerebral infarction) is the most common stroke type, which accounts for 60%~80% of all stroke, and strengthens its etiology, pathogenesis, prevention and prevention. And the study of treatment can provide more alternative ways to reduce its incidence and reduce its bad prognosis. But repeatable, a better simulated animal model for the pathological process of ischemic stroke is a vital factor in the study of ischemic brain damage. The rat middle cerebral artery occlusion model is prepared by the thread embolus method. A model of acute focal cerebral ischemia is the most widely used model at present. Its modeling method, infarct volume and neural function loss are all stable. However, there is still a certain failure rate of modeling because of lack of relative objective and convenient evaluation methods. Laser Doppler cerebral blood flow monitoring can be accurate during the process of cerebral cortex blood perfusion during the reaction modeling. Objective to investigate the role of laser Doppler cerebral blood flow monitoring in the evaluation of rat middle cerebral artery occlusion model by thread emboli, and to provide more objective criteria for the evaluation of the model preparation. Methods the thread plug was inserted into the intracranial segment of the internal carotid artery of 30 SPF Wistar Han rats (16 + 0.5), (18 + 0.5) and (20 + 0.5) m, respectively. M, 3 focal cerebral ischemia models were prepared (10 rats each). 6 h after ischemia and reperfusion, all experimental rats were evaluated by Longa neurobehavioral score. Then the infarcts in the middle cerebral artery were divided into incomplete occlusion group based on whether the skull base had blood clots and 2,3,5 chlorination three phenyl four nitrogen, and the total occlusion group and the over deep obstruction group were 3. The blood flow of the cerebral cortex in the cerebral cortex of the middle cerebral artery of each rat after the occlusion of the intracranial segment of the internal carotid artery and the pulling out thread embolus was monitored and recorded by the laser Doppler method. The blood flow of the cerebral cortex in the blood supply area of the middle cerebral artery was represented by the relative flow single PU value; the cerebral cortex after the obstruction and after the reperfusion was carried out. In the process of making the model, 1 rats died, 9 rats were included in the incomplete obstruction group, 15 in the complete obstruction group and 5 in the deep blocking group. The insertion depth of the incomplete occlusion group was 8 in the rats of (16 + 0.5) mm, and the anterior cerebral artery could not be completely prevented from the middle cerebral artery. Blood flow, Longa score 0~1 score of rats after 6 h ischemia; no blood clot around the skull base artery ring, no infarct after TTC staining. There were 9 rats with deep occlusion group insertion depth (18 + 0.5) mm. The blood flow of the anterior cerebral artery was completely blocked. After 6 h of ischemia, the rats had obvious nerve function loss, Longa score 2~3, and cranial artery ring. There was no blood clot around and TTC staining showed the presence of infarct in the middle cerebral artery supply area. There were 5 rats (20 + 0.5) mm in the deep occlusion group, which could completely block the blood flow of the anterior cerebral artery. After 6 h ischemia, the nerve function was seriously missing, the Longa score was 3~4, and the blood clot of the skull base was visible and the TTC staining was visible. Infarcts in the middle artery supply area. The cerebral cortex blood flow of the rats in the complete occlusion group and the over deep block group was lower than that before the occlusion (94 + 17 to 256 + 36,43 + 9, 286 + 44,44 + 6 and 294 + 6, 294 +, respectively, P0.05). The difference between the groups was statistically significant (F= 56.57, P0.01). The blood flow of the complete obstruction group and the over deep block group was clear. There was no significant difference in the total occlusion group (P0.05). There was no significant difference between the complete occlusion group and the over deep obstruction group (P0.05); the percentage of the 3 groups and the obstructive anterior cerebral cortex was (36.93 + 0.06)%, (15.09 + 0.02)%, (15.52 + 0.04)%, and the difference between the groups was statistically significant (F=39.14, P0.01). The cerebral cortex blood flow (213 + 31147 + 17,96 + 14 respectively) in the deep blocking group was significantly higher than that of the obstruction (P0.05). The difference between the groups was statistically significant (F=50.05, P0.01). The cerebral cortex blood flow was significantly lower than that in the complete occlusion group (P0.05), and the percentage of the 3 group and the obstructive forebrain blood flow was (83.10 + 0.02)%, (51.83 + 0.05)%, respectively. (33.49 + 0.09)%, the difference was statistically significant (F=93.23, P0.01). The change of cerebral cortex blood flow measured by laser Doppler was used as a criterion for the success of MCAO ischemia model, and its sensitivity and specificity were higher than that of neurobehavioral score (93.33 vs 80.00,92.86 vs78.57). A real-time, convenient, minimally invasive, objective and reliable evaluation criterion for the success of the rat MCAO cerebral ischemia model prepared by the method of thread emboli was used to evaluate the sensitivity and specificity of the rat model. The sensitivity and specificity of the evaluation were higher than that of the neurobehavioral score.

【學位授予單位】：新鄉(xiāng)醫(yī)學院
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R743.3;R-332

【參考文獻】

相關期刊論文 前10條

1 吳亞哲;陳偉偉;;中國腦卒中流行概況[J];心腦血管病防治;2016年06期

2 涂雪松;;缺血性腦卒中的流行病學研究[J];中國臨床神經(jīng)科學;2016年05期

3 曹澤標;周小青;余望貽;陳娉婷;劉旺華;;芻議大鼠線栓法MCAO模型尚待完善之處[J];中國中醫(yī)基礎醫(yī)學雜志;2016年01期

4 馬浚寧;高俊瑋;侯博儒;任海軍;劉吉星;陳四化;嚴貴忠;;光化學栓塞法建立缺血性腦卒中動物模型[J];中國組織工程研究;2015年49期

5 王鵬成;任長虹;曾現(xiàn)偉;吉訓明;李寧;高志峰;季泰令;;4種神經(jīng)功能評分法在大鼠局灶性腦缺血模型中的比較研究[J];濰坊醫(yī)學院學報;2014年02期

6 潘紅;孫芳玲;王文;安宜;艾厚喜;張麗;蔣瑩;;缺血性腦卒中的治療藥物及其有效治療時間窗的研究進展[J];中國康復理論與實踐;2013年03期

7 崔景軍;何嬌君;李晶;杜元灝;;大鼠大腦中動脈梗死模型的評價標準探討[J];天津中醫(yī)藥;2013年01期

8 陳茉弦;敖麗娟;李琦;潘芳;;腦卒中動物模型的建立與比較[J];中國康復醫(yī)學雜志;2011年08期

9 沈斌;Xu Haoliang;;線栓法制備SD大鼠局灶性腦缺血/再灌注模型的改良研究[J];首都醫(yī)科大學學報;2007年06期

10 劉亢丁,宮萍,吳江,李玉林,饒明俐;實驗性局灶性腦缺血不同腦區(qū)VEGF、VEGFR-1、2表達及意義[J];中風與神經(jīng)疾病雜志;2003年04期

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