高压氧治疗对大鼠脑挫裂伤后认知功能和细胞凋亡的影响

Influence of hyperbaric oxygenation on posttraumatic cognitive function and apoptosis in rats with brain contusion

目的:探讨高压氧对脑挫裂伤的治疗作用与对细胞凋亡影响之间的关系。方法:实验于2001-03/2002-05在上海交通大学医学院附属第三人民医院神经外科实验室进行。选择SD雄性大鼠109只,随机分为假手术组、高压氧治疗组和脑损伤组,使用Morris水迷宫实验测试大鼠伤前及伤后的认知功能;分别应用透射电镜、原位末端标记法(TUNEL)和流式细胞技术对各组动物挫伤灶旁和海马结构的细胞凋亡情况进行检测。结果:各组大鼠全部进入结果分析,无脱落。①Morris水迷宫实验结果:脑外伤后大鼠逃生时间显著延长(P<0.01),而高压氧治疗使逃生时间明显缩短(P<0.05);②各组动物挫伤灶旁和海马结构的细胞凋亡情况:假手术组无细胞凋亡,损伤组和治疗组存在细胞凋亡,细胞凋亡的发生在伤后24h达到高峰,高压氧治疗组在伤后24h和48h细胞凋亡发生率显著低于相应的损伤对照组(P<0.05)。结论:脑挫裂伤后大鼠的认知功能显著减退,高压氧可以显著改善脑外伤后下降的神经功能;高压氧治疗对脑挫裂伤后细胞凋亡的发生有显著影响,抑制细胞凋亡很可能是高压氧对脑挫裂伤治疗作用的重要机制。

AIM： To investigate the relationship between the therapeutic effect of hyperbaric oxygenation on traumatic brain contusion and its impact on apoptosis. METHODS： The experiment was carried out in the laboratory of the Department of Neurosurgery, Third People＇ s Hospital affiliated to the Medical College of Shanghai Jiaotong University from March 2001 to May 2002. Totally 109 male SD rats were randomly assigned to sham-operated group, hyperbaric oxygenation group and brain injury group. The cognitive function of rats was tested with Morris water maze before and after injury respectively. The apoptosis around injured sites and in hippocampal formation was evaluated with transmission electronic microscope, terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling （TUNEL） and flow cytometry. RESULTS： All the rats were involved in the analysis of results without deletion.① Results of Morris water maze： The escape latency of the injured mrs was significantly prolonged （P 〈 0.01）, but it was markedly shortened in the hyperbaric oxygenation group （P 〈 0.05）. ② Apoptosis of neuronal cells was detected in injured cortex and hippocampus, which reached a peak at 24 hours in the cortex and 48 hours in the hippocampus. The incidences of apoptosis at 24 and 48 hours were significantly lower in the hyperbaric oxygenation group than in the brain injury group （P 〈 0.05）. CONCLUSION： Rats after traumatic brain contusion had markedly declined cognitive function, and hyperbaric oxygenation could significantly improve the decreased neurological function. Hyperbaric oxygenation has great influence on the incidence of apoptosis after traumatic brain contusion, and the anti-apoptosis is closely interrelated to the therapeutic effect of hyperbaric oxygenation on traumatic brain injury.