早期高压氧治疗对急性脊髓损伤大鼠诱导型一氧化氮合酶的影响及疗效评价  

Effect of early hyperbaric oxygen therapy on the expression of inducible nitric oxide synthase in acute spinal cord injury and it＇s therapeutic implications

作　　者：薛磊[1] 张旭[2] 古菁[2] 吴刚传[1] 陈辉强[3] 叶水林[2] 刘晓辉[1] 黄怀[2] 

机构地区：[1]南方医科大学南方医院高压氧治疗中心,广州510515 [2]广州军区总医院神经医学专科医院神经康复二科 [3]广州军区总医院骨科医院

出　　处：《中华物理医学与康复杂志》2013年第3期167-171,共5页Chinese Journal of Physical Medicine and Rehabilitation

基　　金：广东省科技计划项目（20108031600264）

摘　　要：目的探讨早期高压氧（HBO）治疗对急性脊髓损伤大鼠诱导型一氧化氮合酶（iNOS）活性表达变化的影响及疗效评价。方法选取70只健康sD大鼠按随机数字表法分为对照组、假手术组、SCI组、HBO2h组、HBO4h组、HBO6h组和HBO8h组，每组10例。将SCI组、HBO2h组、HBO4h组、HBO6h组和HBO8h组大鼠均采用改良的Allen法制成T8～T9急性脊髓损伤模型（打击后大鼠尾部痉挛摆动、双侧下肢瘫痪，诱发电位测定值明显异于对照组，表明制模成功）；假手术组只进行硬膜囊暴露手术但不打击损伤脊髓；对照组不做任何处理。对照组、假手术组和SCI组仅饲养不做高压氧处理；HBO2h组、HBO4h组、HBO6h组和HBO8h组分别在制模成功后2、4、6和8h始置于动物实验纯氧舱内行高压氧治疗，每日1次，连续7d。分别于制模成功时和高压氧治疗完成时2个时间点，采用Gale等建立的联合行为评分（CBS）法对各个损伤组大鼠后肢功能进行神经学评定，使用神经肌电图机检测运动诱发电位（MEP）评价大鼠肢体功能。在HBO治疗结束后24h内处死所有大鼠取材，取材后用重氮比色法测定iNOS表达量，用硝酸还原酶法测定一氧化氮（NO）含量。将所得数据进行统计学分析比较。结果SCI组、HBO2h组和HBO4h组在实验期间各死亡1只，余67只大鼠纳入结果分析。①治疗结束后，脊髓损伤的大鼠脊髓组织中iNOS检测显示，SCI组iNOS测定值为（0．64±0．13）U／L，表达量最高；iNOS表达量逐渐明显降低，以HBO8h组最为明显（P〈0．05），HBO8h组iNOS值为（0．36±O．10）U／L，表达量最低，且与其它各组间差异有统计学意义（P〈0．05）；但脊髓损伤各组大鼠的iNOS值仍高于假手术组的（0．33±0．07）U／L和对照组的0U／L，且组间差异均有统计学意义（P〈0．05）。②HBO治疗结束后，对照组、假手术组和SCI组大鼠血清中NO的测定量分别Objective To explore inducible nitric oxide synthase （iNOS） activity expression in the early stages of hyperbaric oxygen （HBO） therapy for acute spinal cord injury （SCI） and its therapeutic potential. Methods Seventy rats were randomly divided into a treatment group （including four sub-groups） and a control group （including three sub-groups）. Acute SCI was induced at T8-T9 in both groups using the modified Allen method. The four subgroups of the treatment group were treated with HBO at 2, 4, 6 and 8 hours after the injury, respectively. After 7 HBO therapy sessions, combined behavioral scores （CBSs） and evoked potentials were used to assess the rats＇ limb function. Diazo colorimetric determination was used to detect iNOS expression and the nitrate reductase method was used to determine the content of nitric oxide. Results Compared with the control group and the other treatment subgroups, the 8 hour group recovered motor function the best. iNOS expression and NO production were reduced, and the differences were statistically significant. Conclusion HBO administered 8 hours after acute spinal cord injury had the best effect in reducing synthesis of iNOS and promoting motor function recovery.

关 键 词：高压氧 脊髓损伤 诱导型一氧化氮合酶 一氧化氮 

分 类 号：R651.2[医药卫生—外科学]