CAJ | 학술논문

背景:中枢神经再生失败的主要原因之一是损伤后中枢神经内的微环境(缺乏生长所需的神经营养因子、分泌产生抑制因子、胶质瘢痕形成等)不利于轴突的再生.为了促进中枢神经系统损伤后轴突再生,改善损伤区再生微环境很重要.其中嗅鞘细胞是近年来最为吸引人注目的一种治疗中枢神经损伤的有力工具.目的:探讨嗅鞘细胞在大鼠颅脑损伤中的作用及其是否能在颅脑损伤后减少神经功能上的缺失.设计:以实验动物为研究对象,随机对照实验研究.单位:一所大学医院的神经外科.材料:实验在2003-04/08在开封铁路医院神经外科中心实验室完成.选用成年健康Spraque-Dawley大鼠100只,雌雄不拘,体质量250～350 g,随机分为正常组,脑损伤组,生理盐水组,嗅鞘细胞组.每组25只.每组再分为5个亚组,每个亚组5只大鼠.干预:制备颅脑损伤的大鼠模型,在受伤后立即将嗅鞘细胞移植到受损的脑组织中,1,4 d,1,2,4周对大鼠进行神经损伤评分,将大鼠处死观察嗅鞘细胞在脑组织中的分布情况.主要观察指标:①大鼠的神经功能恢复情况.②嗅鞘细胞在脑组织中的分布情况.结果:在术后2,4周时,嗅鞘细胞组NSS评分与脑损伤组和生理盐水组相比,差异有显著性意义.通过苏木精-伊红染色切片中的形态结构或GFAP和p75免疫化学,可见嗅鞘细胞在移植部位存活并迁移到周围邻近组织.统计不同时间段的5个6μm厚的冠状位组织切片中的p75阳性细胞总量,发现嗅鞘细胞的数量随着时间的推移逐渐变少.结论:颅脑创伤后立即移植嗅鞘细胞到创伤的脑组织,嗅鞘细胞可在移植部位存活并迁移到周围邻近组织,与对照组相比,给予嗅鞘细胞能显著的降低颅脑创伤后引起的神经运动功能障碍.
배경:중추신경재생실패적주요원인지일시손상후중추신경내적미배경(결핍생장소수적신경영양인자、분비산생억제인자、효질반흔형성등)불리우축돌적재생.위료촉진중추신경계통손상후축돌재생,개선손상구재생미배경흔중요.기중후초세포시근년래최위흡인인주목적일충치료중추신경손상적유력공구.목적:탐토후초세포재대서로뇌손상중적작용급기시부능재로뇌손상후감소신경공능상적결실.설계:이실험동물위연구대상,수궤대조실험연구.단위:일소대학의원적신경외과.재료:실험재2003-04/08재개봉철로의원신경외과중심실험실완성.선용성년건강Spraque-Dawley대서100지,자웅불구,체질량250～350 g,수궤분위정상조,뇌손상조,생리염수조,후초세포조.매조25지.매조재분위5개아조,매개아조5지대서.간예:제비로뇌손상적대서모형,재수상후립즉장후초세포이식도수손적뇌조직중,1,4 d,1,2,4주대대서진행신경손상평분,장대서처사관찰후초세포재뇌조직중적분포정황.주요관찰지표:①대서적신경공능회복정황.②후초세포재뇌조직중적분포정황.결과:재술후2,4주시,후초세포조NSS평분여뇌손상조화생리염수조상비,차이유현저성의의.통과소목정-이홍염색절편중적형태결구혹GFAP화p75면역화학,가견후초세포재이식부위존활병천이도주위린근조직.통계불동시간단적5개6μm후적관상위조직절편중적p75양성세포총량,발현후초세포적수량수착시간적추이축점변소.결론:로뇌창상후립즉이식후초세포도창상적뇌조직,후초세포가재이식부위존활병천이도주위린근조직,여대조조상비,급여후초세포능현저적강저로뇌창상후인기적신경운동공능장애.
BACKGROUND: One of the main causes of the failure of central nerve regeneration is that the microenvironment (lack of nerve growth factor, inhibitory factor produced by excretion and formation of glial scar) in the injured central nerves is not favorable for the regeneration of axons. Therefore, it is important to improve the microenvironment of injured area for the regeneration of axons. Recently, olfactory ensheathing cells (OECs) have been attracting much attention as a key method to treat central nervous injury.OBJECTIVE: To investigate the effect of OECs on traumatic brain injury (TBI) in rats and whether they can reduce neurological impairment after TBI.DESIGN: A randomized controlled experimental trial based on experimental animals.SETTING: Department of neurosurgery in a hospital affiliated to a university.MATERIALS: The experiment was conducted in the Central Laboratory of Department of Neurosurgery, Kaifeng Railway Hospital from April 2003 to August 2003. Altogether 100 healthy adult SD rats of either gender,weighting 250- 350 g, were randomly divided into four groups: normal group, TBI group, normal saline group and OEC group with 25 rats in each. Each group was further divided into five subgroups with 5 rats in each.INTERVENTIONS: The models of TBI in rats were established, and OECs were transplanted into brain tissues immediately after injury. The scores of nerve injury were assessed in the rats at day 1, day 4, week 1, week 2 and week 4. The distribution of OECs in brain tissues was observed after the rats were sacrificed.MAIN OUTCOME MEASURES: Neurological function recovery of rats and distribution of OECs in brain tissues.RESULTS: At week 2 and week 4 after operation, neurological severity scores (NSS) in OEC group significantly differed from those of TBI group and normal saline group. HE staining or immunohistochemistry of GFAP and p75 revealed that OECs could survive in the transplanted site and migrate toward the surrounding tissues. The total number of p75 positive cells in five coronal tissue slices of 6 μm thick was added up at different intervals. The results showed that the number of OECs was decreased with the passing time.CONCLUSION: OECs can survive in the transplanted site and migrate to the surrounding tissues when they are transplanted into the iujured brain tissues immediately after TBI. Giving OECs can reduce neurological and motor dysfunction induced by TBI.