高温对重型颅脑损伤后乳酸、Na^+-K^+-ATP酶和脑水肿的影响  

Effect of Hyperthermia on Content of Lactate and Activity of Na^+-K^+-ATPase in Cerebral Tissues and Brain Edema In Rats with Traumatic Brain Injury

作　　者：李玉斌[1] 刘运生[2] 冯继[1] 杨丽敏[1] 徐立新[2] 赵贤军[2] 罗超[2] 

机构地区：[1]秦皇岛市第一医院神经外科,河北秦皇岛066000 [2]中南大学湘雅医院神经外科,湖南长沙410008

出　　处：《中国临床神经外科杂志》2008年第6期354-357,共4页Chinese Journal of Clinical Neurosurgery

基　　金：河北省科学技术研究与发展指导计划项目(072761830)

摘　　要：目的探讨大鼠重型颅脑损伤后高温对伤灶区脑组织乳酸、Na+-K+-ATP酶和脑水肿的影响。方法90只SD大鼠随机分为假手术组、颅脑损伤组、伤后高温组,每组又按处死时间点(伤后4h、1d、3d、5d和7d)分为五个亚组,每亚组6只。取伤灶区脑组织测含水量、乳酸含量和Na+-K+-ATP酶活性并行电镜检查。结果高温组脑组织含水量和乳酸含量在伤后各时间点均显著高于颅脑损伤组和假手术组(P<0.05),而Na+-K+-ATP酶含量显著低于颅脑损伤组和假手术组(P<0.05),电镜检查发现高温组神经细胞肿胀、血脑屏障破坏程度较颅脑损伤组明显加重。结论颅脑损伤后高温增加脑组织乳酸生成,同时Na+-K+-ATP酶活性下降,脑水肿加重,故在颅脑损伤后应保持体温在正常范围内,避免体温升高。Objective To explore effects of hyperthermia on contents of lactate, activity of Na^＋-K^＋-ATPase in the cerebral tissues and brain edema in rats with severe traumatic brain injury （sTBI）. Methods Ninety healthy adult Sprague-Dawley rats were randomly divided into three groups： sham operation group （SO group）, sTBI group and posttraumatic hyperthermia group （PTH group）. Six rats in each group were sacrificed 4 hours, 1 day, 3 days, 5 days and 7 days after sTBI. The samples of the injured brain tissues were collected to determined the contents of water and lactate, and the activity of Na^＋-K^＋-ATPase, and the ultrastructure of the cerebral tissues was observed by an electron microscope. Results Four hours, 1 day, 3 days, 5 days and 7 days after sTBI, the contents of water and lactate in PTH group were significantly higher than those in sTBI group and SO group （P〈0.05） and the activity of Na^＋-K^＋-ATPase in PTH group was significantly lower than that in the other two groups （P〈0.05）. Swelling of neurons and destruction of blood-brain barrier were more severe in PTH group than those in sTBI group and SO group. Conclusions Hyperthermia can produce increase in the concents of lactate, the decrease in the activity of Na^＋-K^＋-ATPase in the cerebral tissues, and aggravation of brain edema in the rats with sTBI. It is highly important to keep normal body temperature after sTBI.

关 键 词：颅脑损伤 高温 乳酸 NA^+-K^+-ATP酶 脑水肿 

分 类 号：R651.15[医药卫生—外科学]