亚低温对大鼠脑创伤性非断离轴突损伤继发断离的影响  

Effects of hypothermia on secondary axotomy of nondisruptive axonal injury after diffuse brain injury in rats

作　　者：陈革[1] 惠国桢[3] 周建宏[1] 陆爻忠[1] 蒋云召[1] 王泳[1] 冯淑静[2] 李成万[2] 

机构地区：[1]无锡市第三人民医院神经外科,214041 [2]无锡市第三人民医院中心实验室,214041 [3]苏州大学附属第一医院神经外科

出　　处：《中华创伤杂志》2009年第4期314-316,共3页Chinese Journal of Trauma

基　　金：无锡市社会发展科研计划资助项目（CS045006）

摘　　要：目的研究亚低温对创伤性非断离轴突损伤（nondisruptive axonal injury，NDAI）继发断离的影响，探讨其治疗价值。方法将16只雄性SD大鼠采用随机数字表法分为亚低温组（32℃，持续6h）和对照组（37．5℃）各8只，液压冲击致大鼠脑弥散性损伤，非磷酸化神经丝蛋白（NF68）免疫组化显示肿胀轴突及轴突球，比较两组伤后24h、72h胼胝体区、间脑中脑区、桥脑延脑区和小脑区肿胀轴突及轴突球最大密度变化。结果伤后24h，亚低温组各计数区肿胀轴突及轴突球明显减少（P〈0．05），间脑中脑区、桥脑延脑区、小脑区尤为显著（P〈0．01）；而伤后72h，亚低温组仅在距冲击部位较远的桥脑延脑区、小脑区减少（P〈0．05，P〈0．01），距冲击部位较近的胼胝体区、间脑中脑区不明显（P〉0．05）。结论亚低温早期无论对损伤轻或重的NDAI均可延滞其继发断离的进程，但随着时间推移，这种效应逐渐减弱，仅对损伤较轻的NDAI有效，亚低温可能阻断部分损伤较轻的NDAI的继发断离。Objective To investigate curative effects of hypothermia on the secondary axotomy of nondisruptive axonal injury （NDAI） after diffuse brain injury （DBI）. Methods A total of 16 male Sprague-Dawley rats were randomly and equally divided into hypothermia group （at 32℃ for 6 hours） and control group （ at 37.5% ）. The axonal swelling and axonal balls were detected by means of NF68kD immunochemistry after DBI caused by fluid percussion. The changes of maximal density of axonal swelling and axonal bails in callosum, diencephalon-mesencephalon, pons-oblongata and cerebellum were compared 24 and 72 hours after injury between both groups. Results NF68kD immunoehemistry well showed axonal swellings and axonal balls in whole brain. The axonal swelling and axonal balls were significantly decreased 24 hours after DBI in both groups （ P 〈 0.05 ） , especially in diencephalon-mesencephaIon, pons-oblongata and cerebellum （P 〈 0.01 ）. While there showed significant decrease of axonal swellings and axonal balls in pons-oblongata and cerebellum in hypothermia group 72 hours after DBI （P 〈 0. 05, P 〈 0. 01 ） but insignificant changes in the callosum and the diencephalon-mesencephalon compared with control group （ P 〉 0.05 ）. Conclusions Hypothermia can retard the progress of mild or severe NDAI at early stage, which would taper with the longer time after injury except for partial mild NDAI. Hypothermia may prevent mild NDAI from secondary axotomy.

关 键 词：脑损伤 轴突 低温 

分 类 号：R651.15[医药卫生—外科学] R364.4[医药卫生—临床医学]