高压氧暴露对兔脑爆炸伤后脑组织水通道蛋白4的表达及血液灌注的影响  

Effcts of HBO on the expression of AQP-4 and perfusion following cerebral blast injury in rabbits

作　　者：刘家传 孙文江 张永明 杨艳艳 汤宏 李兵仓[2] 张良潮[2] 

机构地区：[1]解放军第一0五医院神经外科,合肥230031 [2]第三军医大学附属大坪医院野战外科研究所

出　　处：《中华航海医学与高气压医学杂志》2012年第3期163-166,共4页Chinese Journal of Nautical Medicine and Hyperbaric Medicine

基　　金：南京军区联勤部卫生部“十一五”重点基金项目（06219）;南京军区医学科技创新课题（092009）

摘　　要：目的通过研究高压氧（hyperaricoxygen，HBO）暴露对兔脑爆炸伤后脑组织水通道蛋白4（aquapodins-4，AQP-4）的表达及血液灌注的影响，探讨爆炸伤后脑水肿的形成机制。方法150只新西兰大白兔采用数字表法随机分为对照组、高压氧治疗组（HBO组）和非治疗组。HBO组与非治疗组用纸雷管爆炸制作兔脑爆炸伤模型，随后分别随机分为伤后lh、6h、12h、24h、72h、7d、14d7个亚组，每亚组10只，对照组10只。采用RT-PCR法测定兔脑组织中AQP-4mRNA的表达，磁共振灌注成像（perfusionweightedimaging，PWI）检测伤后不同时间点伤后脑组织血液灌注情况。结果AQP-4mRNA在伤后1h表达开始上调，3d达峰值，7d后缓慢下调。经HBO早期治疗，在6h后各时间点AQP-4mRNA表达均明显下调（P〈0．05）。如伤后6h，非治疗组AQP-4mRNA相对量为0．5184-0．088，HBO组为0．327±0．027。经PWI检测，非治疗组伤后早期灌注明显下降，12h后灌注逐渐上升，并保持一定灌注量（接近对照组）持续2周；伤后早期（1-6h）治疗组灌注下降更为明显。结论HBO早期治疗可有效提高兔爆炸伤后脑组织血氧分压，增加血氧含量，缓解脑组织缺氧引起的继发性脑水肿。Objective Mechanism of cerebral edema following blast injury in rabbits through the study of the expression of aquapodins- 4 （ AQP- 4 ） introduced by HBO, and perfusion as well, after cerebral blast injury. Methods One hundred and fifty New Zealand rabbits were randomly divided into the treatment group, the non-treatment group and the control group （ l0 animals ）. The animal model of cerebral blast injury was developed by using paper detonator. The treatment and the non-treatment groups were randomly divided into the 1 h, 6 h, 12 h, 24 h, 72 h, 7 d and 14 d sub-groups, each consisting of 10 animals. The expression of AQP- 4 mRNA was measured with RT-PCR, and the perfusion of the brain tissue was detected with perfusion weighted imaging （PWI） at each time points, following cerebral injury. Results The expression of AQP-4 mRNA began to increase 1 h after injury, reached peak in 72 h, and then decreased at day 7. Following initial HBO treatment, the expression of AQP- 4 mRNA significantly decreased at various time points after 6 hours （ P 〈 O. 05 ）. PWI test indicated that blood perfusion for the non-treatment group significantly decreased in the initial stage of injury, however, 12 h after injury perfusion gradually increased, and the amount of perfusion （ close to the control group） was maintained for 2 weeks. For the treatment group, perfusion decreased more significantly in the early stages of injury （ 1-6 b）. Conclusions Early HBO therapy could enhance the partial pressure of oxygen in the affected brain tissue, increase blood oxygen content and alleviate secondary cerebral edema induced by cerebral ischemia.

关 键 词：高压氧 爆炸伤 水通道蛋白4 灌注成像 

分 类 号：R82[医药卫生—临床医学]