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机构地区:[1]首都医科大学大兴医院神经外科,北京102600 [2]北京天坛医院神经外科
出 处:《中华神经外科杂志》2008年第3期210-212,共3页Chinese Journal of Neurosurgery
基 金:基金项目:北京市委组织部优秀人才资助项目
摘 要:目的采用立体定向电解毁损大鼠下丘脑多个有效部位来复制下丘脑毁损的动物模型,观察下丘脑毁损的范围与机体水钠代谢变化及其生存状况之间的关系。方法将大鼠分为四组,分别进行电解毁损和对照。各组分别于术前、术后第1天至第7天内每日测量血钠和尿钠浓度,记录每日尿量。计算各组术后3d和7d死亡率,术后1周灌注大鼠固定取脑,肉眼及显微镜下分别观察下丘脑形态学变化。结果从各组手术前后自身比较看,A1组术后第1,2,3,4,5,6天和第7天血钠均较本组术前血钠显著升高;A2组术后第1天及第2天血钠均较本组术前血钠显著降低。从各组术后与其对照组比较看,A1组与对照组B组相比术后第2,3,4,5天血钠显著升高,术后第3,4,5,6天24h尿钠显著降低,A2组与对照组B组相比术后第1,2天血钠显著降低,术后第2天24h尿钠显著降低。结论大鼠单侧下丘脑的水钠代谢中枢毁损不会引起水钠代谢紊乱,大鼠水钠代谢中枢不存在优势半球之分。而双侧下丘脑的水钠代谢中枢毁损后会引起严重的血钠紊乱,以持续性血钠升高多见,但出现持续性血钠降低时后果将更为严重。Objective By using a stereotaxic instrument, the rat model of hypothalamic electrolytic lesions was made in some objective parts by a direct current to observe the relationships among the extent of hypothalamic electrolytic lesions and metabolic changes of water/sodium and the surviving state of rats. Method Four groups were studied. The concentrations of the serum sodium and the 24h urine sodium before the lesion operation and at 1st, 2nd, 3rd, 4th, 5th, 6th, 7th days after operation were measured. The volume of the urine was recorded everyday, and the mortality within 3 days and the mortality within 7 days after operation were calculated. The brains were fixed and morphological changes were observed. Results In Group A1, the concentrations of the serum sodium at 1st, 2nd, 3rd, 4th, 5th, 6th, 7th days after operation were significantly higher than that before operation. In Group A2, the concentrations of the serum sodium at 1st, 2nd days after operation were significantly lower than that before operation. The concentrations of the serum sodium at 2nd, 3rd, 4th, 5th days after operation in Group A1 were significantly higher than that in Group B at the same time point. The 24h urine sodium at 3rd, 4th, 5th, 6th days after operation in Group A1 were significantly lower than that in Group B at the same time point. The concentrations of the serum sodium after operation in Group A2 were significantly lower than that in Group B at the same time point. The 24h urine sodium after operation in Group A2 was significantly lower than that in Group B at the same time point. Conclusions Our study shows that the water and sodium metabolic center is functionally identical. However, the lesion in unilateral hypothalamus caused the disorder of serum sodium seriously, and a majority of cases are continually with hypernatremia, while some others with continually hyponatremia, this is a appalling consequence.
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