CAJ | 학술논문

目的动态监测创伤性脑损伤(traumatic brain injury,TBI)后大鼠体感诱发电位(somatosensory evoked potential,SEP)和定量脑电图(quantitative electroencephalogram,QEEG)的变化,探讨亚低温对TBI大鼠的神经保护作用及预后判断. 方法取健康成年雄性SD大鼠40只,按随机数字表法分为正常对照组(未经任何外加干预措施)、假手术组(只开骨窗,不钻孔)、TBI组(应用液压冲击仪制作中重度TBI模型)和亚低温(TBI后即刻连续给予冰毯物理降温,维持肛温32～35℃,持续6h后复温至37℃),每组10只.各组分别于处理后6,24 h、7d监测TBI大鼠SEP和QEEG变化. 结果 (1)SEP的变化:与TBI组比较,亚低温组24h时伤侧P1波和N1波潜伏期即开始缩短,且差异有统计学意义(P＜0.05),7d时P1波和N1波潜伏期接近假手术组.(2) QEEG的变化:除正常对照组和假手术组,TBI组各时相点均表现为α节律减慢,反应性慢波增多,QEEG相对功率谱值下降或消失;亚低温组反应性慢波减少,伴以少量α波,24h和7d时相对功率谱值升高,尤以24h组升高明显,但仍低于正常对照组(P＜0.05). 结论亚低温治疗可缩短TBI后SEP潜伏期,提高QEEG相对功率谱值,改善神经传导和脑电活动,具有神经保护作用.
목적 동태감측창상성뇌손상(traumatic brain injury,TBI)후대서체감유발전위(somatosensory evoked potential,SEP)화정량뇌전도(quantitative electroencephalogram,QEEG)적변화,탐토아저온대TBI대서적신경보호작용급예후판단. 방법 취건강성년웅성SD대서40지,안수궤수자표법분위정상대조조(미경임하외가간예조시)、가수술조(지개골창,불찬공)、TBI조(응용액압충격의제작중중도TBI모형)화아저온(TBI후즉각련속급여빙담물리강온,유지항온32～35℃,지속6h후복온지37℃),매조10지.각조분별우처리후6,24 h、7d감측TBI대서SEP화QEEG변화. 결과 (1)SEP적변화:여TBI조비교,아저온조24h시상측P1파화N1파잠복기즉개시축단,차차이유통계학의의(P＜0.05),7d시P1파화N1파잠복기접근가수술조.(2) QEEG적변화:제정상대조조화가수술조,TBI조각시상점균표현위α절률감만,반응성만파증다,QEEG상대공솔보치하강혹소실;아저온조반응성만파감소,반이소량α파,24h화7d시상대공솔보치승고,우이24h조승고명현,단잉저우정상대조조(P＜0.05). 결론 아저온치료가축단TBI후SEP잠복기,제고QEEG상대공솔보치,개선신경전도화뇌전활동,구유신경보호작용.
Objective To investigate the effect of mild hypothermia on neuroprotection and prognosis prediction of rats with traumatic brain injury (TBI) by dynamically monitoring the somatosensory evoked potentials (SEP) and quantitative electroencephalogram (QEEG).Methods Forty healthy adult male SD rats were randomly divided into four groups according to random number table,ie,normal control group (with no intervention),sham operation group (fenestration only,without drilling),TBI group (fluid percussion was used to produce moderate to severe TBI),and mild hypothemia group (ice blanket was used immediately after TBI for continuous physical cooling and rectal temperature was maintained at 32-35℃ and rewarmed to 37℃ 6 hours after the initiation of cooling),with 10 rats per group.Changes of SEP and QEEG in all groups were monitored at 6,24 hours,and 7 days after TBI.Results (1) Compared with TBI group,the latency of SEP waves (P1 and N1) on the injured side in mild hypothemia group began to shorten at 24 hours(P ＜ 0.05) and were close to that in the sham operation group at 7 days.(2) Except for normal control group and sham operation group,QEEG in TBI group showed decrease of α rhythm,increase of reactivity slow waves,and decrease or disappearance of QEEG relative power spectral values at all time points.In mild hypothermia group,the reactivity slow waves were decreased with a small amount of α wave; QEEG relative power spectral values were increased at 24 hours and 7 days (especially at 24 hours),but werc still lower than those in normal control group (P ＜ 0.05).Conclusion Mild hypothermia exerts neuroprotective effect through reducing SEP latency,raising relative power spectral values of QEEG,and improving the nerve conduction and brain electrical activity of the injured side.