CAJ | 학술논문

目的：研究去骨瓣减压术对大鼠创伤性脑损伤后脑水肿、水孔蛋白-4（AQP-4）表达的影响。方法：应用改良Feeney’s自由落体脑损伤打击装置制成大鼠创伤性脑损伤模型，分为假手术组（SO组）、对照组（C组）及去骨瓣减压组（DC组），各组在损伤后再分为6、12、24、72、120 h及168 h等6个时间点断头取脑损伤区组织。分别利用干湿重量法测量脑组织含水量和Western-Blot检测AQP-4蛋白的表达。结果：大鼠去骨瓣减压组脑组织含水量及AQP-4蛋白表达呈现先升高后降低的趋势，于伤后24 h达高峰后逐渐下降。与C组相比，上述指标含量均有所下降：脑组织含水量在24、120、168 h差异有统计学意义（P<0.05），72 h差异有高度统计学意义（P<0.01）；AQP-4蛋白表达在12、120 h时间点有统计学意义（P<0.05），24、168 h时有高度统计学意义（P<0.01）。结论：创伤后大鼠脑组织脑水肿与AQP-4表达上调密切相关；去骨瓣减压术可减轻脑水肿，减缓AQP-4表达。该手术对创伤性脑损伤的保护机制可能与减缓AQP-4蛋白表达，从而减轻脑水肿和继发性脑损伤，保护脑组织有关。
목적：연구거골판감압술대대서창상성뇌손상후뇌수종、수공단백-4（AQP-4）표체적영향。방법：응용개량Feeney’s자유락체뇌손상타격장치제성대서창상성뇌손상모형，분위가수술조（SO조）、대조조（C조）급거골판감압조（DC조），각조재손상후재분위6、12、24、72、120 h급168 h등6개시간점단두취뇌손상구조직。분별이용간습중량법측량뇌조직함수량화Western-Blot검측AQP-4단백적표체。결과：대서거골판감압조뇌조직함수량급AQP-4단백표체정현선승고후강저적추세，우상후24 h체고봉후축점하강。여C조상비，상술지표함량균유소하강：뇌조직함수량재24、120、168 h차이유통계학의의（P<0.05），72 h차이유고도통계학의의（P<0.01）；AQP-4단백표체재12、120 h시간점유통계학의의（P<0.05），24、168 h시유고도통계학의의（P<0.01）。결론：창상후대서뇌조직뇌수종여AQP-4표체상조밀절상관；거골판감압술가감경뇌수종，감완AQP-4표체。해수술대창상성뇌손상적보호궤제가능여감완AQP-4단백표체，종이감경뇌수종화계발성뇌손상，보호뇌조직유관。
Objective:To research the effects of decompressive craniectomy on traumatic brain injury by investigating the changes of brain edema, the expression of AQP-4 in Rats. Method:The experimental TBI model was established by bumpiness of free falling body according to Feeney’s. Three groups were investigated:sham-operated group(SO),control group(C)and decompressive craniectomy group(DC). Decompressive craniectomy was performed at injury side immediately after brain insult. All animals were killed 6,12,24,72,120,168 h later. The rat brain tissue of injury side were examined for water content(wet/dry weight)and protein expression of AQP-4(western blot)respectively. Result:After TBI,water content of brain tissue and the protein expression of AQP-4 in injury region began to increase after brain insult. They reached summit at 24 h after insult,afterward dropped grdualaly. There was significantly positive correlation between expression of AQP-4 protein and the change of brain water content. Compared with the control group,brain water content and the expression of AQP-4 protein were decreased in the decompressive craniectomy group. Conclusion:The change of AQP-4 protein exression are closely related to the formation and development of brain edema during the early stage after traumatic brain injury. The early up-regulated expression of AQP-4 may increase the level of brain edema after the brain injury. And decompressive craniectomy has protective effects on traumatic brain injury by the mechanism of decreasing the expression of AQP-4 and thereby alleviating brain edema.