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术前慢性疼痛易化术后认知功能障碍及其中缝背核5-HT机制研究
Pre-operative pain facilitates post-operative cognitive dysfunction and the mechanism of 5-HT in dorsal raphe

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DOI:
作者:
陈思涵
Sihan Chen
作者单位:
上海交通大学医学院附属仁济医院，麻醉科
Department of Anesthesiology, Renji Hospital, Shanghai Jiaotong University School of Medicine.
关键词:
术后认知功能障碍；术前慢性疼痛；五羟色胺；中缝背核
postoperative cognitive dysfunction; preoperative chronic pain; serotonin; dorsal raphe nucleus
摘要:
目的 观察足底注射完全弗氏佐剂（CFA）的慢性炎性疼痛大鼠模型在Morris水迷宫（MWM）中的行为学表现及中缝背核（DR）中色氨酸羟化酶(TPH)的表达情况，并对麻醉前后的变化进行比较。方法 34只雄性SD大鼠(12~14周龄)随机分为四组，生理盐水组（n=8）、生理盐水+麻醉组（n=9）、CFA组（n=8）以及CFA+麻醉组（n=9），使用MWM测试各组大鼠的认知功能水平。比较各组之间MWM探索测试中目标象限的时间百分比以及反转测试中的潜伏期长短；使用免疫组化和Western blot法测定各组大鼠DR中TPH的表达情况。结果 注射CFA的大鼠在第二次MWM探索测试中目标象限时间百分比低于注射生理盐水的大鼠（P<0.05）、反转测试中潜伏期长于注射生理盐水的大鼠（P<0.01）；CFA+麻醉组大鼠在第三次MWM探索测试中目标象限时间百分比低于生理盐水组（P<0.01）、反转测试中潜伏期长于CFA组（P<0.01）。免疫荧光显示CFA+麻醉组DR区中活化的5-HT能神经元减少，以及Western blot显示其DR中TPH含量减少。结论 术前慢性疼痛可易化大鼠术后认知功能的下降以及减少DR中TPH的含量。
Objective To observe the behavior of rats with chronic inflammatory pain that were injected with complete Freund’s adjuvant (CFA) at the plantar surface of rats’ hind paw by Morris Water Maze (MWM), determine the expression of tryptophan hydroxylase (TPH) in Dorsal Raphe Nucleus (DR), and compare the variation before and after anesthesia in the groups. Methods Thirty-four male SD rats (n=34) were randomly divided into four groups, Group Saline(n=8), Group Saline+Sevoflurane(n=9), Group CFA(n=8) and Group CFA+Sevoflurane(n=9) , and estimated the cognitive level of the rats by MWM. We compared the percentage time spent in the target quadrant in the probe trials and the latency period in reversal trainings of MWM by the groups. Also we determined the expression of TPH in DR through immunohistochemistry and Western blot methods. Results The percentage time spent in the target quadrant in the second MWM probe trials of rats with CFA injection was lower than those with saline injection (P<0.05), whereas the latency period of reversal trainings was longer (P<0.01). The percentage time spent in target quadrant in the third MWM probe trials of rats in Group CFA+Sevoflurane was lower than those in Group Saline (P<0.01), the latency period in the third MWM reversal trainings of rats in Group CFA+Sevoflurane was longer than those in Group CFA (P<0.01). Immunofluorescence results showed that the quantity of activated serotonergic neurons in DR of rats in Group CFA+Sevoflurane was reduced and Western blot results showed that the content of TPH in DR of rats in Group CFA+Sevoflurane was declined. Conclusion Pre-operative chronic pain can facilitate post-operative cognitive dysfunction and reduce the TPH content in DR of rats.

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