脊髓缺血再灌注损伤对兔脊髓微循环的影响*
Effects of spinal cord ischemia？？reperfusion injury on rabbit spinal cord microcirculatory

目的：探讨脊髓缺血再灌注损伤(SCIRI)对脊髓微循环的影响。方法：采用肾下腹主动脉阻断模型,分别阻断兔腹主动脉30（C30组）、45（C45组）和60 min（C60组）后再灌注, 假手术组（C0组）不阻断血流。于缺血前、缺血期间、再灌注期间监测脊髓微循环血流速度和微循环血流量（SCMBF），再灌注120 min后观察脊髓组织中丙二醛(MDA)含量，诱生型一氧化氮合酶（iNOS）、髓过氧化物酶（MPO）、活性氧（ROS）活力，核转录因子？拨？Bp65 (NF？拨？Bp65)、抑制蛋白？拨？Bα(I？拨？Bα)和细胞间黏附分子？？1（ICAM？？1)蛋白的表达及脊髓病理学变化。结果：C30、C45、C60组脊髓组织分别表现为轻、中、重度SCIRI病理学改变。缺血再灌注期间，4组脊髓微循环血流速度和SCMBF的变化差异有统计学意义（F组间=12.051和54.514，F时间=66.084和171.028，F交互=12.032和35.752，P均<0.05）；C45、C60组再灌注120 min时SCMBF仍未恢复至术前水平（P<0.05）。再灌注120 min 时，C0、C30、C45、C60组脊髓组织中MDA含量和iNOS、MPO、ROS活力依次增高（P<0.05），NF？拨？Bp65和ICAM？？1蛋白表达依次增强（P<0.05），I？拨？Bα表达依次降低（P<0.05）。结论：脊髓微循环状态能够敏感而准确地反映SCIRI程度, ICAM？？1和NF？拨？Bp65表达上调加重脊髓微循环障碍。
To investigate the effects of spinal cord ischemia？？reperfusion injury(SCIRI) on spinal cord microcirculatory.Methods: The kidney ventral aorta block model was established and the rabbit abdominal aorta were blocked for 0(C0 group), 30(C30 group), 45(C45 group) and 60(C60 group) min, respectively.During ischemia and reperfusion, velocity and microcirculation blood flow(SCMBF) were monitored. After 120 min reperfusion, the pathological observation of spinal cord tissue was performed, and malondialdehyde(MDA) content, the activity of inducible nitric oxide synthase(iNOS), myeloperoxidase(MPO), reactive oxygen species(ROS), nuclear factors？？kappa Bp65 (NF？拨？Bp65), inhibitor？？kappa Bα(I？拨？Bα) and intercellular adhesion molecule？？1(ICAM？？1) protein expression were detected. Results: The C30, C45, C60 group performanced mild, medium and heavy SCIRI pathological manifestations. During the period of ischemia and reperfusion, the differences in changes of the velocity and SCMBF among the four groups were statistically significant (Fgroup=12.051 and 54.514,Ftime=66.084 and 171.028, Finteraction=12.032 and 35.752, P<0.05); SCMBF of C45, C60 groups still had not returned to preoperative levels after 120 min reperfusion(P<0.05). After 120 min reperfusion, MDA content and the activity of iNOS, MPO and ROS in C0, C30, C45, and C60 groups increased in turn(P<0.05), the NF？拨？Bp65 and ICAM？？1 expression increased in turn(P<0.05), and I？拨？Bα expression reduced(P<0.05). Conclusion: Spinal cord microcirculation monitoring can sensitively and accurately reflect the degree of SCIRI. The upregulation of the expressions of ICAM？？1 and NF？拨？Bp65 might aggravate the spinal cord SCIRI during microcirculatory dysfunction