摘要
摘要目的应用低温人工脑脊液对大鼠脑外伤伤灶局部冲洗治疗,检测脑组织中水含量和血管内皮生长因子(VEGF)表达的变化,探讨人工脑脊液局灶冲洗对创伤性脑损伤的治疗作用及可能的脑保护机制.方法采用自由落体打击装置制备大鼠创伤性脑损伤模型,分正常对照组、外伤对照组、局灶人工脑脊液冲洗治疗组及局灶低温人工脑脊液冲洗治疗组.于伤后３０min开始分别以３７oC人工脑脊液及２５oC人工脑脊液进行局灶冲洗治疗,维持３h;伤后４h、１、３、５、７d处死留取脑组织标本,采用干湿重法测伤灶脑组织含水量,RT－PCR方法检测VEGFmRNA的表达.结果与外伤对照组相比,人工脑脊液治疗组伤灶脑组织水含量明显降低(p＜０．０５);脑外伤后４h伤灶脑组织中VEGFmRNA表达即明显上升,１d达到高峰,持续至３d,５d开始下降,７d降至正常水平;局灶冲洗治疗后,伤后４h、１d、３d和５d各组脑组织VEGFmRNA表达均低于外伤对照组相应各时间点(P＜０．０５);其中以局灶低温人工脑脊液冲洗治疗效果最佳.结论局灶低温人工脑脊液冲洗治疗能明显减轻伤灶脑水肿,有良好的治疗作用;调节VEGF的表达是其脑保护作用的机制之一.关键词局灶冲洗,脑损伤,脑水肿,血管内皮生长因子EffectofFocalIrrigationwithHypothermicArtificialCerebrospinalFluidonBrainEdemaandVEGFafterExperimentalTraumaticBrainInjuryLIChuang－hua,LIUYun－sheng,LIUHong－wei．(１DepartmentofNeurosurgery,TheBrainHospitalofHunan,Changsha,４１０００７．２DepartmentofNeurosurgery,XiangyaHospital,CentralSouthUniversity,Changsha,４１０００８,China)AbstractObjectiveToinvestigatetheeffectoffocalirrigationwithhypothermicartificialcerebrospinalfluidonbrainedemaandtheexpressionofvascularendothelialgrowthfactor(VEGF)followingtraumaticbraininjury(TBI)inrats．MethodRatswereunderwentseverelateralcontrolledcorticalimpactbraininjuＧry．ThirtyminutesafterTBI,focalirrigationtreatmentwasimplementwith３７oCor２５oCartificialcerebrospinalfluid,andmaintainedfor３hours．RatsweredeＧcapitated４h,１day,３days,５days,７daysafterinjury．Thepercentageofwaterintheinjuredparietalcerebralcortex,aswellasVEGFmRNAweremeasured．ResultInTBIrats,significantlyelevatedbrainedemawasdetectedat４h,１,３daysafterTBIintheinjuredparietalcerebralcortex,andbegantodeclineat５and７days．Thisriseinbrainedemawassignificantlyreducedwithposttraumaticfocalirrigation,especiallytreatedwithartificialcerebrospinalfluid．AfterTBI,theexpressionofVEGFmRNAweresignificantlyincreasedat４h,peakedat１~３d,andmaintainhighat５dcomparedwithNormalgroup(P＜０．０５)．TheexpressionofVEGFwassignificantlyreducedat４h,１d,３d,and５daftertreatedwithfocalirrigation,especiallytreatedwithhypothermicartificialcerebrospinalfluid．ConＧclusionFocalirrigationwithhypothermicartificialcerebrospinalfluidcanreducetraumaticbrainedemasignificantly．ToregulatetheexpressionofVEGFmaybeoneofitsneuroprotectivemechanisms．KeywordsFocalirrigation;Artificialcerebrospinalfluid;Traumaticbraininjury;Brainedema;Vascularendothelialgrowthfactor中图分类号R４５４文献标识码B文章编号１００８－６３１５(２０１５)１２－１２２１－０２血管内皮生长因子具有促进血管生成,增加血管及血脑屏障通透性的作用,与脑水肿的形成有密切关系.在本课题组此前研究基础上,本文进一步研究人工脑脊液伤灶冲洗对脑外伤的治疗作用及其对血管内皮生长因子的影响,探讨其疗效及可能的脑保护机制.
出版日期
2015年12月22日（中国期刊网平台首次上网日期，不代表论文的发表时间）
