缺氧对急性硬膜下血肿大鼠发生外伤性脑肿胀的影响  

Effects of hypoxia on the formation of traumatic brain swelling in rats with acute subdural hematoma

作　　者：鲜亮 陈力 林珑 叶丹 魏梁锋 王守森 Xian Liang;Chen Li;Lin Long;Ye Dan;Wei Liangfeng;Wang Shousen(Department of Neurosurgery,Fuzong Clinical College of Fujian Medical University(900th Hospital),Fuzhou 350025,China)

机构地区：[1]福建医科大学福总临床医学院(第九〇〇医院)神经外科,福州350025

出　　处：《中华创伤杂志》2024年第9期826-836,共11页Chinese Journal of Trauma

基　　金：联勤医学重点专科(神经外科)项目(LQZD⁃SW);福建省科技计划科技创新平台项目(2022Y2017);中国人民解放军联勤保障部队第九〇〇医院战创伤救治专项指令性项目(2022ZL03)。

摘　　要：目的探讨缺氧对急性硬膜下血肿(ASDH)大鼠发生外伤性脑肿胀(TBS)的影响。方法取45只SD大鼠,按随机数字表法分为五组,每组9只:假手术常氧组,作假手术操作,置于密闭容器中通入空气;假手术缺氧组,作假手术操作,置于氧气体积分数8%的密闭容器中进行缺氧诱导;ASDH常氧组,制作ASDH模型,置于密闭容器中通入空气;ASDH缺氧组,制作ASDH模型,置于氧气体积分数8%的密闭容器中进行缺氧诱导;ASDH缺氧+吸氧组,制作ASDH模型并缺氧诱导后持续吸入体积分数40%的氧气。每组各取6只大鼠在造模后立即通过开颅观察术中脑膨出的情况,评估TBS程度;使用激光散斑成像系统在造模前、开颅术前、开颅术后即刻观察微血管血流量。每组剩余3只大鼠分别在造模后直接处死,取脑组织标本。Western blot检测造模后0、30、60 min的周细胞α⁃平滑肌肌动蛋白(α⁃SMA)和血小板衍生生长因子受体⁃β(PDGFR⁃β)蛋白表达量。免疫荧光染色检测造模后0 min的周细胞α⁃SMA、PDGFR⁃β和微血管标记物血小板⁃内皮细胞黏附分子31(CD31)的表达情况。结果造模后,假手术常氧组无脑膨出;假手术缺氧组脑膨出高度为0.5(0.0,1.0)mm,与假手术常氧组差异无统计学意义(P>0.05);ASDH常氧组脑膨出高度为2.2(2,2.5)mm,较假手术常氧组和假手术缺氧组均显著增高(P<0.01);ASDH缺氧组脑膨出高度为3.1(2.9,3.2)mm,较假手术常氧组、假手术缺氧组和ASDH常氧组均显著增高(P<0.01);ASDH缺氧+吸氧组脑膨出高度为2.8(2.7,2.9)mm,较ASDH缺氧组差异无统计学意义(P>0.05),较假手术常氧组、假手术缺氧组和ASDH常氧组显著增高(P<0.01)。造模前、开颅术前和开颅术后,假手术常氧组微血管血流量分别为224.2±49.7、224.8±50.3、225.1±50.3,假手术缺氧组分别为224.7±43.7、220.9±45.9、221.8±45.5,两组间差异均无统计学意义(P>0.05);ASDH常氧组微血管血流量分别为226.5±52.7、17Objective To explore the effects of hypoxia on traumatic brain swelling(TBS)in rats with acute subdural hematoma(ASDH).Methods Forty⁃five SD rats were divided into 5 groups according to the random number table method,with 9 rats in each group:sham surgery normal oxygen group which underwent sham surgical procedures and were placed in a closed container with ventilation,sham surgery hypoxia group which underwent sham surgical procedures and were placed in a closed container with oxygen volume fraction of 8%for hypoxia induction,ASDH normal oxygen group which made into the ASDH model and placed in a closed container with ventilation,ASDH hypoxia group were made into the ASDH models and placed in a closed container with oxygen volume fraction of 8%for hypoxia induction,and ASDH hypoxia+oxygen inhalation group which inhaled oxygen continuously with oxygen volume fraction of 40%after being made into the ASDH models and induced for hypoxia.Six rats were selected from each group immediately after the modeling and craniotomy was performed to observe the brain swelling during the surgery and evaluate the degree of TBS.Microvascular blood flow was observed by laser speckle imaging system before modeling,before craniotomy,and immediately after craniotomy.The remaining 3 rats in each group were killed directly after modeling and brain tissue specimens were collected.The expression levels of pericellular proteinα⁃smooth muscle actin(α⁃SMA)and platelet⁃derived growth factor receptor⁃β(PDGFR⁃β)at 0,30 and 60 minutes after modeling were detected through Western blot analysis.The expression levels ofα⁃SMA,PDGFR⁃βand microvascular marker platelet⁃endothelial cell adhesion molecule 31(CD31)at 0 minute after modeling were tested through immunofluorescent staining.Results No brain bulge was observed in the sham surgery normal oxygen group.The height of brain bulge in sham surgery hypoxia group was 0.5(0.0,1.0)mm,with no significant difference from that in the sham surgery normal oxygen group(P>0.05);it was 2.2

关 键 词：脑损伤 大鼠 缺氧 周细胞 微循环 

分 类 号：R651.15[医药卫生—外科学]