椎体火器伤对脊髓细胞凋亡的影响  

Expression of Apoptosis after Gunshot Injury to Spine

作　　者：梁朝革[1] 陈长青[2] 丁真奇[2] 陈梓峰[2] 贾连顺[3] 

机构地区：[1]上海市长宁区中心医院骨科,200336 [2]解放军第175医院 [3]上海长征医院

出　　处：《中国骨与关节损伤杂志》2006年第11期894-896,共3页Chinese Journal of Bone and Joint Injury

基　　金：全军"十五计划"指令性课题基金(项目编号01L056)

摘　　要：目的建立家猪L2椎体贯通火器伤实验模型,通过免疫组织化学方法观察不同弹速火器伤对伤段脊髓组织Caspase-3表达及细胞凋亡的影响。方法18只家猪,随机分为两组(L组:微型冲锋枪组,n=10;H组:狙击步枪组,n=8),在全麻状态下建立L2椎体侧方贯通伤模型,观察比较两组弹道入口及出口面积比值、脊髓损伤范围及伤段脊髓组织Caspase-3表达及细胞凋亡情况。结果两组弹道出口/入口面积比、硬膜下血肿范围、Caspase-3表达及细胞凋亡程度比较有显著差异(P<0·01)。多元线性回归分析及变量筛选显示两组细胞凋亡程度与脊髓大体损伤范围及Caspase-3的表达程度具有相关性。结论在脊髓火器伤的早期阶段,细胞凋亡程度同枪弹导致脊髓损伤程度及Caspase-3的表达程度相关。Objective To establish a L2 vertebral body gunshot injury （GSI） model and to investigate the effect of different velocity bullet on the expression of caspase - 3 and apoptosis in spinal cord after GSI to spine caused by different velocity bullets. Methods Eighteen healthy pigs were randomly divided into tow groups： the assault rifle group （L group, Low velocity group, n = 8） and the snipe gun groups （H groups, High velocity group, n = 10）. L2 bodies were targeted by assault rifle or snipe gun bullets. The animals were sacrificed at 3 hours after injury. The ballistic entrance, outlet and injury of spinal cord size were measured. Then the sections were stained with imunohistochemistry and TUNEL. The expression of caspase - 3 and the rates of TUNEL - positive cells were compared respectively. Results There were significant differences in the size （P 〈 0.01 ）, the scve, ity in the injuries of spinal cord and the ballistic outlet and entrance ratio （P 〈 0.01 ）. The expression caspase- 3 and TUNEL- positive cells were significantly increased in the snipe gun groups compared with that in assault rifle group after GSI （P 〈 0.05 or 0.01 ）. The multiple linear regression analysis revealed significant associations of the rates of TUNEL- positive cells with the severity of the injuries of spinal cord and the expression of caspase - 3. Conclusion The bullet velocity is one of the most important determinant factors in the tissue wounding. The experimental demonstration caspase - 3 plays an important role in the early stage of secondary events in GSI to spine.

关 键 词：脊髓 火器伤 白细胞介素1β转化酶3 细胞凋亡 

分 类 号：R64[医药卫生—外科学]