目的 探讨丙戊酸钠(SV)对蛛网膜下腔出血(SAH)大鼠模型超敏C反应蛋白(hsCRP)的影响及减轻脑血管痉挛损伤的作用. 方法 72只雄性SD大鼠按随机数字表法分为4组:假手术组、SAH组、SAH+生理盐水(NS)组、SAH+SV组,每组18只;后3组通过枕大池注血法建立SAH模型,后2组在SAH模型建立后每日腹腔注射生理盐水或SV(2 mg/100 g).分别抽取各组大鼠模型建立后1d、3d、5d及10d时血液,采用散射免疫比浊法测定hsCRP水平;分别于模型建立后3d、5d取各组大鼠进行神经功能评分. 结果 SAH组和SAH+NS组在模型建立后1d、3d、5d及10d时的hsCRP水平[(0.29±0.01) mg/L、(0.32±0.02) mg/L、(0.35±0.02) mg/L、(0.32±0.02) mg/L;(0.28±0.02) mg/L、(0.31±0.02) mg/L、(0.34±0.02) mg/L、(0.31±0.02) mg/L]均较假手术组[(0.09±0.02)mg/L、(0.09±0.02) mg/L、(0.09±0.02) mg/L、(0.09±0.01) mg/L]明显升高,差异均有统计学意义(P＜0.05);而SAH+SV组hsCRP水平[(0.15±0.02) mg/L、(0.21±0.02) mg/L、(0.24±0.02) mg/L、(0.15±0.03)mg/L]均较假手术组明显增高,但均较SAH组和SAH+NS组明显降低,差异均有统计学意义(P＜0.05).SAH组和SAH+NS组在模型建立后3d、5d的神经功能评分[(14.1±0.8)分、(11.9±0.9)分;(13.9±0.7)分、(11.1±1.4)分]均较假手术组[(26.7±0.5)分、(26.6±0.5)分]明显降低,差异有统计学意义(P＜0.05);而SAH+SV组神经功能评分[(23.0±0.8)分、(21.8±1.4)分]亦均较假手术组明显降低,但均较SAH组和SAH+NS组明显增高,差异均有统计学意义(P＜0.05). 结论 SV可通过降低SAH后hsCRP水平抑制炎症反应,减轻脑血管痉挛损伤,从而改善神经功能.%Objective To explore the effect of sodium valproate (SV) on reducing high-sensitivity C-reactive protein (hsCRP) and attenuating cerebrovascular spasm damage in rats after subarachnoid hemorrhage (SAH).Methods Seventy-two male rats,weighting 300-400 g,were randomized to following experimental groups:sham-operated group,SAH group,SAH+saline treatment group,and SAH+SV treatment group (n=18).The SAH models in the later three groups were induced by injection of autologous blood into the cistern magna.Saline or SV (2 mg/100 g) was given to the rats in the SAH+saline treatment group and SAH+SV treatment group every day via intraperitoneal injection.Serum hsCRP level was measured on 1,3,5 and 10 day.Neurological deficit scale scores were assessed on 3 and 5 day.Results On 1,3,5 and 10 day,HsCRP level in the sham-operated group was (0.09± 0.02) mg/L,(0.09±0.02) mg/L,(0.09±0.02) mg/L and (0.09±0.01) mg/L;that in SAH group was (0.29± 0.01) mg/L,(0.32±0.02) mg/L,(0.35±0.02) mg/L and (0.32±0.02) mg/L;that in SAH+saline treatment group was (0.28±0.02) mg/L,(0.31 ±0.02) mg/L,(0.34±0.02) mg/L and (0.31 ±0.02) mg/L;that in SAH+SV treatment group was (0.15 ±0.02) mg/L,(0.21 ±0.02) mg/L,(0.24±0.02) mg/L and (0.15 ±0.03) mg/L;HsCRP level in the SAH group and SAH+saline treatment group was significantly higher than that in the sham-operated group (P＜0.05);HsCRP level in the SAH+SV treatment group was significantly increased as compared with that in the sham-operated group,but significantly decreased as compared with that in the SAH+saline treatment group and SAH group (P＜0.05).The neurobehavior scale scores on 3 and 5 day in SAH+SV treatment group (23.0±0.8 and 21.8±1.4) were significantly increased as compared with those in the SAH group (14.1±0.8 and 11.9±0.9) and SAH+saline treatment group (13.9± 0.7 and 11.1±1.4,P＜0.05);those in the SAH+SV treatment group (23.0±0.8 and 21.8±1.4) were significantly decreased as compared with that in the sham-operated group,but significantly increased as compared with that in the SAH+saline treatment group and SAH group (P＜0.05).Conclusion SV decreases the inflammatory injury by reducing the hsCRP level and improve the neurological outcome in SAH rat models.
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