伤灶局部亚低温、引流治疗对创伤性脑损伤时Na^+、脑含水量及TNF-α的变化  

Treatment effects of focus hypothermia and drainage on traumatic brain injury of Sprague-dawley rats

作　　者：罗超[1] 刘运生[1] 赵贤军[1] 李玉斌[1] 徐立新[1] 

机构地区：[1]中南大学湘雅医学院湘雅医院神经外科

出　　处：《重庆医学》2006年第9期818-820,共3页Chongqing medicine

摘　　要：目的研究伤灶局部引流、伤灶局部亚低温联合治疗对SD大鼠创伤性脑损伤后脑水含量、Na+含量、肿瘤坏死因子变化的影响,以探讨伤灶局部引流、伤灶局部亚低温对创伤性脑损伤的治疗作用及可能机制。方法采用自由落体打击装置造成大鼠创伤性脑损伤,分别在伤后30min开始实施伤灶局部引流、25℃循环水对伤灶脑组织进行局部降温至(31.5±0.5)℃,而对假脑外伤组及脑外伤模型组不降温,各组在相应时间点断头处死;采用干湿重法测伤灶脑组织含水量,原子吸收火焰分光光度法测Na+含量,采用RT-PCR法检测伤灶区脑组织中肿瘤坏死因子基因表达情况、免疫组化实验检测其蛋白水平。结果(1)脑含水量:FH组、FD组、FDH组伤灶区脑组织含水量分别低于M组,差异有统计学意义(P<0.05);FDH组水含量低于FD组和FH组,差异有统计学意义(P<0.05)。(2)脑组织钠含量:脑组织钠离子变化与含水量变化一致。(3)伤灶区脑组织TNF-αmRNA含量:FH组、FD组、FDH组伤灶区脑组织TNF-αmRNA含量分别低于M组,差异有统计学意义(P<0.05);FDH组TNF-αmRNA含量低于FD组和FH组,差异有统计学意义(P<0.05)。(4)伤灶区脑组织中TNF-α蛋白含量趋势TNF-αmRNA变化一致。(5)引流量:FD组、FDH组引流量分别为(0.230 8±0.035 6)g(、0.345 6±0.069 2)g。结论伤灶局部亚低温、伤灶局部引流分别单独或联合均对创伤性脑损伤有治疗作用,并且联合治疗组疗效胜于单一治疗组。这种治疗效果可能是通过直接引流出水肿液和脑脊液、减轻脑水肿、减轻炎症反应等途径发挥作用。Objective To investigate the effect of the focus hypothermia group, the focus drainage group, the group of united focus hypothermia and focus drainage on traumatic brain injury of Sprague-dawley rats and its mechanism. Methods Feeney＇s model was used to produce traumatic brain injury in Sprague-dawley rats. After half an hour, both the focus hypothermia group and the group of united focus hypothermia and drainage were received focus brain hypothermia with 25℃ circling water except for the model group, the sham operation group and the focus drainage group. The injured rats were sacrificed at preconcerted time. Results Water content of the focus hypothermia group, the focus drainage group as well as the united group was markedly less than that of model group （P 〈0.05）. The concentration of brain sodium coincided with that of water content （P〈0. 05）. Expression of TNF- α mRNA in the brain tissue of the focus hypothermia group, the focus drainage group, the united group were less than those of model group （P〈0.05）. Compared with traumatic model group, TNF-α protein amount decreased significantly （P〈0.05）. Conclusion The focus hypothermia group, the focus drainage group, the group of united local hypothermia and local drainage showed great effect on traumatic brain edema. Its mechanism may be anti-express TNF-α, decreasing brain edema.

关 键 词：引流 亚低温 创伤性脑损伤 肿瘤坏死因子 联合治疗 

分 类 号：R651[医药卫生—外科学]