【摘要】 目的：为探讨脑缺血再灌注对大鼠耳蜗形态学及听觉的影响。方法：采用闭塞大鼠四动脉脑缺血模型，观察了脑缺血３０分钟及再灌注不同时间大鼠耳蜗结构和听阈的动态变化，形态学观察应用光镜、扫描电镜与透射电镜，听力测定采用 ４０Ｈｚ听觉相关电位（４０ Ｈｚ ＡＥＲＰ）技术。结果：缺血 ３０分钟和再灌注 ２小时、２４小时、７２小时 ４０Ｈｚ　ＡＥＲＰ反应阈与缺血前比较显著提高（Ｐ＜０．０１），随再灌注时间延长听阈逐渐降低。病理变化特点是再灌注期间Ｃｏｒｔｉ’ｓ器部分外毛细胞缩短、肿胀或坏死，听毛紊乱、脱落；螺旋神经节神经元数目减少；线粒体水肿变性，内质网高度扩张、囊泡变。再灌注７天后，听力和细胞损伤逐渐恢复。结论：脑缺血再灌注可致突发性听力下降和耳蜗细胞损伤，该研究为缺血性内耳损伤的防治提供了实验依据。更多还原

【Abstract】 To investigate the effect of brain ishchemia and reperfusion on morphology and hearing of cochlea, a four--vessel occlusion rat model was used, and the changes of the hearing thresholds and structure of the cochlea were observed at 30 min after brain ishcemia and at different reperfusion time. Morphological observation was made by light scanning and transmission electron microscopy, while the hearing thresholds were recorded with 40Hz auditory event related potential (40Hz AERP). The results showed that after 30 min ischemia and reperfusion for 2 h, 24 h and 72 h, the 40Hz AERP response threshold was significantly higher than before the ischemia(P< 0.01). Hearing thresholds decreased progressively with the prolongation of the reperfusion time. The pathological examination showed shortening or swelling and necrosis of some outer hair cells of Corti’s organ, derangement or shedding of the sensory cilias, the reduced number of spiral ganglion cell, hydropic degeneration of the mitochondria, dilatation of the endoplasmic reticulum. These results suggested that sudden hearing loss and cochlea cell damage could be induced by brain ischemia and reperfusion. The study provides the experimental evidence for the prevention and therapy of ischemic damage of inner ear.更多还原