CAJ | 학술논문

目的探讨高压氧治疗兔颅脑爆震伤后应激性溃疡的疗效.方法 90只新西兰大白兔采用随机数字表法分为正常对照组10只、爆震伤组40只和高压氧治疗组(高压氧组)40只.爆震伤组和高压氧组采用纸雷管爆炸建立兔颅脑爆炸伤应激性溃疡模型,各自又分为伤后6,24,72 h和7d4个亚组,每亚组10只.检测各组胃溃疡指数,TUNEL法检测胃黏膜细胞凋亡指数,阿尔辛蓝-过碘酸-希夫(alcian blue-periodic acid-schiff,AB/PAS)染色结合半定量检测兔胃黏膜病理组织学改变.结果正常对照组未发生应激性溃疡和细胞凋亡.爆震伤组伤后6,24,72 h、7d胃溃疡指数分别为12.08±1.02,25.56±0.88,20.36±0.96,17.56±1.12,明显高于高压氧组的8.02±0.58,15.22±1.05,12.39±0.65,9.22±0.79(P ＜0.05).爆震伤组伤后6,24,72 h、7d胃黏膜细胞凋亡指数分别为20.22±1.56,27.56±0.96,24.36±1.23,16.38±1.24,明显高于高压氧治疗组的10.78±0.93,13.89±0.84,10.55±1.58,8.56±1.47(P ＜0.05).爆震伤组胃黏膜AB/PAS阳性层厚度明显变薄或缺失,高压氧治疗组层缺失较轻,差异有统计学意义(P＜0.05).结论高压氧可有效降低兔颅脑爆炸伤后应激性胃溃疡指数和细胞凋亡指数,增加AB/PAS阳性层厚度,减轻胃黏膜损伤.
목적 탐토고압양치료토로뇌폭진상후응격성궤양적료효.방법 90지신서란대백토채용수궤수자표법분위정상대조조10지、폭진상조40지화고압양치료조(고압양조)40지.폭진상조화고압양조채용지뢰관폭작건립토로뇌폭작상응격성궤양모형,각자우분위상후6,24,72 h화7d4개아조,매아조10지.검측각조위궤양지수,TUNEL법검측위점막세포조망지수,아이신람-과전산-희부(alcian blue-periodic acid-schiff,AB/PAS)염색결합반정량검측토위점막병리조직학개변.결과 정상대조조미발생응격성궤양화세포조망.폭진상조상후6,24,72 h、7d위궤양지수분별위12.08±1.02,25.56±0.88,20.36±0.96,17.56±1.12,명현고우고압양조적8.02±0.58,15.22±1.05,12.39±0.65,9.22±0.79(P ＜0.05).폭진상조상후6,24,72 h、7d위점막세포조망지수분별위20.22±1.56,27.56±0.96,24.36±1.23,16.38±1.24,명현고우고압양치료조적10.78±0.93,13.89±0.84,10.55±1.58,8.56±1.47(P ＜0.05).폭진상조위점막AB/PAS양성층후도명현변박혹결실,고압양치료조층결실교경,차이유통계학의의(P＜0.05).결론 고압양가유효강저토로뇌폭작상후응격성위궤양지수화세포조망지수,증가AB/PAS양성층후도,감경위점막손상.
Objective To investigate the effect of hyperbaric oxygen to reduce stress-induced gastric mucosal injury in rabbits with blast-related brain injury.Methods Posttraumatic stress ulcer in a rabbit model of blast-related brain injury was created using paper detonators.Ninety New Zealand white rabbits were randomly divided into normal control group (n =10),blast-related injury group (n =40) and hyperbaric oxygen treatment group (hyperbaric oxygen group,n =40) according to the random number table.Rabbits in blast-related injury group and hyperbaric oxygen group were subgrouped at 6 hours,24 hours,72 hours and 7 days postinjury,with 10 rabbits at each time point.Gastric mucosal injury was detected in aspects of ulcer index,TUNEL method for apoptotic index,and alcian blue-periodic acid-schiff (AB/PAS) staining and semi-quantitative analysis of pathological histology using.Results Neither stress ulcer nor apoptosis occurred in normal control group.At 6 hours,24 hours,72 hours and 7 days postinjury,index of gastric ulcer in blast-related injury group was 12.08 ± 1.02,25.56 ± 0.88,20.36 ±0.96 and 17.56 ± 1.12 respectively,far higher than 8.02 ±0.58,15.22 ± 1.05,12.39 ±0.65 and 9.22 ± 0.79 in hyperbaric oxygen group (P ＜ 0.05) ; apoptotic index in blast-related injury group was 20.22 ± 1.56,27.56 ± 0.96,24.36 ± 1.23 and 16.38 ± 1.24,far higher than 10.78 ± 0.93,13.89 ±0.84,10.55 ± 1.58 and 8.56 ± 1.47 in hyperbaric oxygen group (P ＜ 0.05).Thickness of AB/PAS-positive mucin layers showed marked attenuation even loss in blast-related injury group,but the loss was minor in hyperbaric oxygen group (P ＜ 0.05).Conclusion Hyperbaric oxygen is effective to decrease the stress ulcer index and apoptosis index of gastric mucosa,increase the thickness of AB/PAS positive layer and lighten the gastric mucosal injury of rabbits with blast-related brain injury.