CAJ | 학술논문

目的研究亚低温对创伤性非断离轴突损伤(nondisruptive axonal injury,NDAI)继发断离的影响,探讨其治疗价值.方法将16只雄性SD大鼠采用随机数字表法分为亚低温组(32℃,持续6 h)和对照组(37.5℃)各8只,液压冲击致大鼠脑弥散性损伤,非磷酸化神经丝蛋白(NF68)免疫组化显示肿胀轴突及轴突球,比较两组伤后24 h、72 h胼胝体区、间脑中脑区、桥脑延脑区和小脑区肿胀轴突及轴突球最大密度变化.结果伤后24 h,亚低温组各计数区肿胀轴突及轴突球明显减少(P<0.05),间脑中脑区、桥脑延脑区、小脑区尤为显著(P<0.01);而伤后72 h,亚低温组仅在距冲击部位较远的桥脑延脑区、小脑区减少(P<0.05,P<0.01),距冲击部位较近的胼胝体区、间脑中脑区不明显(P>0.05).结论亚低温早期无论对损伤轻或重的NDAI均可延滞其继发断离的进程,但随着时间推移,这种效应逐渐减弱,仅对损伤较轻的NDAI有效,亚低温可能阻断部分损伤较轻的NDAI的继发断离.
목적 연구아저온대창상성비단리축돌손상(nondisruptive axonal injury,NDAI)계발단리적영향,탐토기치료개치.방법 장16지웅성SD대서채용수궤수자표법분위아저온조(32℃,지속6 h)화대조조(37.5℃)각8지,액압충격치대서뇌미산성손상,비린산화신경사단백(NF68)면역조화현시종창축돌급축돌구,비교량조상후24 h、72 h변지체구、간뇌중뇌구、교뇌연뇌구화소뇌구종창축돌급축돌구최대밀도변화.결과 상후24 h,아저온조각계수구종창축돌급축돌구명현감소(P<0.05),간뇌중뇌구、교뇌연뇌구、소뇌구우위현저(P<0.01);이상후72 h,아저온조부재거충격부위교원적교뇌연뇌구、소뇌구감소(P<0.05,P<0.01),거충격부위교근적변지체구、간뇌중뇌구불명현(P>0.05).결론 아저온조기무론대손상경혹중적NDAI균가연체기계발단리적진정,단수착시간추이,저충효응축점감약,부대손상교경적NDAI유효,아저온가능조단부분손상교경적NDAI적계발단리.
Objective To investigate curative effects of hypothermia on the secondary axotomy of nondisruptive axonal injury (NDAI) after diffuse brain injury (DBI).Methods A total of 16 male Sprague-Dawley rats were randomly and equally divided into hypothermia group (at 32℃ for 6 hours) and control group (at 37.5℃ ).The axonal swelling and axonal balls were detected by means of NF68kD immunochemistry after DBI caused by fluid percussion.The changes of maximal density of axonal swelling and axonal balls in callosum,diencephalon-mesencephalon,pons-oblongata and cerebellum were compared 24 and 72 hours after injury between both groups.Results NF68kD immunochemistry well showed axonal swellings and axonal balls in whole brain.The axonal swelling and axonal balls were significantly decreased 24 hours after DBI in both groups (P<0.05),especially in diencephalon-mesencephalon ,pons-oblongata and cerebellum (P<0.01).While there showed significant decrease of axonal swellings and axonal balls in pons-oblongata and cerebellum in hypothermia group 72 hours after DBI (P<0.05,P<0.01) but insignificant changes in the callosum and the diencephalon-mesencephalon compared with control group (P>0.05 ).Conclusions Hypothermia can retard the progress of mild or severe NDAI at early stage,which would taper with the longer time after injury except for partial mild NDAI.Hypothermia may prevent mild NDAI from secondary axotomy.