大鼠放射性脊髓损伤脊髓血流量变化规律  

Regularity of Spinal Cord Blood Flow Following Radiation-induced Spinal Cord Injury in Rats

作　　者：张晶[1,2] 魏丽 孙万良[2] 章金刚[4] 游华[2] 张伟京[2] 

机构地区：[1]解放军总医院,北京100853 [2]军事医学科学院附属医院淋巴瘤/头颈部肿瘤科,北京100071 [3]重庆市人口和计划生育科学技术研究院,重庆400020 [4]军事医学科学院野战输血研究所三室,北京100850

出　　处：《现代生物医学进展》2013年第15期2801-2803,共3页Progress in Modern Biomedicine

基　　金：国家自然科学基金项目(81001220;30972974);全军医学科研"十二五"课题(CWS11J088);创伤;烧伤与复合伤国家重点实验室开放基金(SKLKF201204);呼吸和肺循环疾病北京市重点实验室开放课题(2011-3);丰台区科技新星计划项目;军事医学科学院附属医院创新科研基金(FC-2012-07);机器人学国家重点实验室开放课题(RLO200810);首都医学发展科研基金项目(2009-3070)

摘　　要：目的:放射性脊髓损伤(Radiation spinal cord injury,RSCI)是头颈部、胸部及上腹部肿瘤放射治疗和射线意外照射时的常见并发症,一般认为,白质坏死、脱髓鞘为其主要的病理学变化。然而,越来越多的证据表明血-脊髓屏障破裂和血管通透性增加等血管损伤远早于白质坏死和脱髓鞘改变。所以本文阐明大鼠放射性脊髓损伤病理生理过程中脊髓血流量变化规律。方法:将60只Sprague-Dawley(SD)大鼠随机分为12组,1组为对照,其余11组采用60Co放射治疗机行30 Gy大鼠颈髓C2-T2单次照射,剂量率为153 cGy/min,源皮距为80 cm,照射时长为1153 s,照射范围为2.0×1.0 cm,对照组大鼠于麻醉后置于60Co放射治疗机下,佯照,照射前及照射后分别采用激光多普勒法测量脊髓血流量,11组大鼠于照射前以及照射后1、3、7、14、21、30、60、90、120、150、180天进行测量,以照射前测量值为基数,各时间点以基数的百分比表示该时间点脊髓血流量。结果:大鼠放射性脊髓损伤后,脊髓血流量在照射早期即有降低,照射后90天达到最低,随后脊髓血流量进入平台期。结论:阐明了大鼠放射性脊髓损伤后脊髓血流量的变化规律。大鼠放射性脊髓损伤可影响脊髓血流量,导致脊髓长期处于持续低灌流、缺血缺氧状态,最终导致脊髓不可逆性损伤。临床上放射性脊髓损伤的病人感到疲乏无力,出现神经系统的症状体征,通常死于脑疝。本文为临床上疲乏无力,出现神经系统的症状体征,死于脑疝放射性脊髓损伤的病人的早期防治提供病理生理基础。Objective： The central nervous system（CNS） is dose-limiting not only in the treatment of CNS tumors,but also in the treatment of head and neck,thoracic,and upper abdominal malignancies.Generally speaking,white matter necrosis,demyelination is the main pathological changes.However,it is reported that vascular injury such as the blood-spinal cord barrier breakdown and vascular permeability changes is much earlier than white matter necrosis and demyelination.Therefore,the objective of this article is to clarify the regularity of spinal cord blood flow following radiation-induced spinal cord injury in rats.Methods： 60 rats were randomly divided into 12 groups before irradiation,one of which served as control group,remaining 11 groups received single dose 30 Gy λ ray beams to a 2.0 cm cervical spine field spanning C2-T2 using 60Co radiation therapy machine.Dose rate is 153 cGy/min,rats is from the radiation source 80 cm.Irradiationtimeis 1153 seconds,irradiationrange is of 2.0×1.0 cm.Rats in control group pretended to receive single dose 30 Gy λ ray and the spinal cord blood flow was measured pre-irradiation and post-irradiation with laser Doppler flow metry.The spinal cord blood flow of 11 groups of rats was measured with laser Doppler flow metry pre-irradiation and post-irradiation 1,3,7,14,21,30,60,90,120,150,180 days.Results： After radiation-induced spinal cord injury in rats,spinal cord blood flow is decreased in the early stage,and reached the lowest point in the 90 days after irradiation,subsequently recovered slightly.Conclusion： Radiation-induced spinal cord injury in rats can affect the spinal cord blood flow as result to spinal cord in rats sustained hypoperfusion,ischemia and hypoxia and eventually lead to spinal cord irreversible damage.Patients often experience fatigue and an increase in neurologic symptoms and signs,and death from brain herniation.This article provides a clinical pathophysiological basis for the early prevention of radiation-induced spinal cord injury.

关 键 词：放射性脊髓损伤 脊髓血流量 Γ射线 照射 

分 类 号：Q953[生物学—动物学] R651.2[医药卫生—外科学]