中华神经外科杂志
中華神經外科雜誌
중화신경외과잡지
Chinese Journal of Neurosurgery
2011年
12期
1281-1284
,共4页
颅脑损伤%失血性休克%超微结构%vWF%复苏
顱腦損傷%失血性休剋%超微結構%vWF%複囌
로뇌손상%실혈성휴극%초미결구%vWF%복소
Craniocerebral trauma%Hemorrhagic shock%Ultrastructure%Von Willevrand factor%Resuscitation
目的 观察小容量高晶体-高胶体渗透压混合液(HHS)复苏对脑外伤合并休克大鼠脑超微结构和Ⅷ因子相关抗原(vWF)表达的影响.方法 SD大鼠54只随机分为:(1)假手术组；(2)脑外伤+休克组；(3)HHS组；每组各18只.脑外伤+休克组和HHS组建立脑外伤合并急性失血性休克模型,随后在HHS组进行小容量HHS复苏.观察各组脑超微结构和vWF的表达.结果 电镜显示HHS对神经元、星形细胞和血脑屏障均有保护作用.脑外伤+休克组在损伤后4h和24h vWF的表达显著减少(P＜0.01),48h开始恢复,但显著低于假手术组和HHS组(P＜0.01)；HHS组在损伤后4h,vWF的表达显著减少(P＜0.0l),24h开始恢复,至48h恢复正常.结论 小容量HHS复苏治疗脑外伤合并休克大鼠,可以抑制脑血管内皮损伤,促进微血管修复,减轻继发性脑损伤.
目的 觀察小容量高晶體-高膠體滲透壓混閤液(HHS)複囌對腦外傷閤併休剋大鼠腦超微結構和Ⅷ因子相關抗原(vWF)錶達的影響.方法 SD大鼠54隻隨機分為:(1)假手術組；(2)腦外傷+休剋組；(3)HHS組；每組各18隻.腦外傷+休剋組和HHS組建立腦外傷閤併急性失血性休剋模型,隨後在HHS組進行小容量HHS複囌.觀察各組腦超微結構和vWF的錶達.結果 電鏡顯示HHS對神經元、星形細胞和血腦屏障均有保護作用.腦外傷+休剋組在損傷後4h和24h vWF的錶達顯著減少(P＜0.01),48h開始恢複,但顯著低于假手術組和HHS組(P＜0.01)；HHS組在損傷後4h,vWF的錶達顯著減少(P＜0.0l),24h開始恢複,至48h恢複正常.結論 小容量HHS複囌治療腦外傷閤併休剋大鼠,可以抑製腦血管內皮損傷,促進微血管脩複,減輕繼髮性腦損傷.
목적 관찰소용량고정체-고효체삼투압혼합액(HHS)복소대뇌외상합병휴극대서뇌초미결구화Ⅷ인자상관항원(vWF)표체적영향.방법 SD대서54지수궤분위:(1)가수술조；(2)뇌외상+휴극조；(3)HHS조；매조각18지.뇌외상+휴극조화HHS조건립뇌외상합병급성실혈성휴극모형,수후재HHS조진행소용량HHS복소.관찰각조뇌초미결구화vWF적표체.결과 전경현시HHS대신경원、성형세포화혈뇌병장균유보호작용.뇌외상+휴극조재손상후4h화24h vWF적표체현저감소(P＜0.01),48h개시회복,단현저저우가수술조화HHS조(P＜0.01)；HHS조재손상후4h,vWF적표체현저감소(P＜0.0l),24h개시회복,지48h회복정상.결론 소용량HHS복소치료뇌외상합병휴극대서,가이억제뇌혈관내피손상,촉진미혈관수복,감경계발성뇌손상.
Objective To evaluate the effects of small -volume resuscitation with hypertonic -hyperoncotic solution (HHS,7.5％ NaCl/10％ hydroxyethyl starch 200/0.5 ) on brain ultrastructure and expression of yon Willevrand factor in traumatic brain injury (TBI) and hemorrhagic shock model of rats.Methods 54 SD rats were divided into 3 groups:sham operated group (group A,n =18),TBI and hemorrhagic shock group (group B,n =18) and HHS treatment group (group C,n =18).All rats in group B and C were subjected to hemorrhagic shock after TBI.The rats in group C were subsequently resuscitated with HHS (4 ml/kg).The Ultrastructure morphology in cortex and hippocampus CA1 region of injured hemisphere were assessed 4 h after TBI and hemorrhagic shock using electronic microscope.The expression of von Willebrand factor (vWF) was evaluated with immunohistochemical staining.Results It demonstrated that HHS has protective effects on neurons,astrocytes and blood-brain barrier in cortex and hippocampus CA1 region in the model of TBI and hemorrhagic shock in rats.Strong positive immunoreactive microvessels of vWF were found in group A.However,in group B,the expression of vWF was decreased significantly at 4 h and 24 h after TBI and hemorrhagic shock ( P＜0.01),and increased at48 h after injury,but it was still lower than those in group A and C ( P ＜0.01).In group C,the expression of vWF was decreased at 4 h after TBI and hemorrhagic shock ( P ＜0.01 ),then increased at 24 h after injury,and restored to normal level at 48 h after injury.Conclusions In the rat model of TBI and hemorrhagic shock,small- volume resuscitation with HHS could attenuate cerebral injury and improve the repair of endotheliocytes of cerebral vessels.
