低氧血症对轻型颅脑损伤大鼠海马结构二次脑损伤的实验研究  

Adverse effects of secondary hypoxemia on mild traumatic brain injury in rats

作　　者：王洪财[1] 王波定[1] 陈海[1] 陈茂送[1] 孙成丰[1] 沈罡[1] 马延斌[2] 

机构地区：[1]宁波市医疗中心李惠利医院神经外科,315040 [2]上海交通大学医学院附属第三人民医院神经外科

出　　处：《浙江医学》2015年第13期1129-1132,1135,共5页Zhejiang Medical Journal

基　　金：宁波市自然科学基金项目(2011A610041);宁波市科学技术基金项目(2013A05)

摘　　要：目的应用低氧血症二次脑损伤大鼠模型,探讨低氧血症对轻型颅脑损伤(mTBI)后海马神经元及轴索组织结构的二次损伤作用。方法采用随机数字表法将大鼠分为正常对照组(8只)、单纯mTBl组(10只)、单纯低氧血症组(10只)及低氧血症二次脑损伤组(10只)。在自制旋转装置致大鼠mTBI基础上,利用动物呼吸机获得控制性低氧血症,从而构建低氧血症二次脑损伤模型。脑损伤后1周,应用HE染色、免疫组化β-APP染色及电镜观察大鼠海马组织结构病理学变化。结果 HE染色发现单纯低氧血症组大鼠海马神经元结构完整、排列有序、神经组织结构致密、未见明显神经元丢失及神经组织结构疏松等病理变化,单纯mTBI组及低氧血症二次脑损伤组大鼠均出现海马神经元肿胀、胞质淡染、密度降低、排列不规则及神经组织结构疏松等损伤表现,但低氧血症二次脑损伤组较单纯mTBI组明显。免疫组化β-APP染色及电镜观察到低氧血症二次脑损伤组大鼠海马存在轴索肿胀扭曲变形、髓鞘板层分离及轴索球形成等轴索损伤表现。结论低氧血症二次脑损伤可明显加重mTBI后海马神经元及轴索组织结构的损伤,及早预防、发现和治疗低氧血症对改善mTBI患者预后具有积极意义。Objective To investigate the effects of post- traumatic hypoxemia on mild traumatic brain injury （mTBI） in rats. Methods The experimental model was established by instantly rotating 90 degree fol owed by hypoxemic insult in rats. Animals in group 1 were subjected to primary mTBI and subsequent hypoxemia（n=10）;animals in group 2 were subjects to mTBI only（n=10）;animals in group 3 underwent hypoxemia only（n=10） and animals in group 4 served as the controls（n=8）. Pathological and behavioral examinations were conducted 1 week after injury. Results Al rats in group 2 and 3 survived after mTBI or hy-poxemia, whereas 2 animals died in group 1 with a mortality rate of 20.0%. Histological examination of HE- stained sections, elec-tron microscope, andβ- APP immunohistochemistry revealed the presence of neuronal and axonal injury in CA3 of hippocampus in rats of group 1. Pathological changes of neuronal injury in group 2 were exhibited, but no additional axonal damage was demonstrated. The above changes were not found in groups 3 and 4. Conclusion The combination of primary mTBI and sec-ondary hypoxemia can cause synergistic effects to produce significantly pathological changes in CA3 of hippocampus in rats.

关 键 词：低氧血症 轻型颅脑损伤 二次脑损伤 

分 类 号：R651.15[医药卫生—外科学]