尼莫地平与β-七叶皂甙钠对弥漫性脑损伤干预的实验研究

Experimental study of intervention of nimodipine and reparil on diffuse brain injury

研究弥漫性脑损伤的发病机制 ,探讨尼莫地平和β-七叶皂甙钠对其治疗的效果。方法 采用 Marmarou大鼠闭合性颅脑损伤模型 ,利用免疫组化、原位细胞凋亡检测、电镜等方法 ,动态观察弥漫性脑损伤后神经元、神经轴索、髓鞘、胶质细胞的变化 ,并结合特殊染色、常规染色法进行观察和分析。实验用 Wistar大鼠 ,分为尼莫地平组和β-七叶皂甙钠组 ,实验动物致伤后 ,分别腹腔注射尼莫地平 2 mg/kg和β-七叶皂甙钠 4mg/kg,于伤后 2 4、48、72 h断头取脑 ,观察脑水肿情况、脑组织中钙、镁含量变化 ,以及细胞凋亡情况。比较两组治疗效果。结果 弥漫性脑损伤后可见轴索及髓鞘的变形 ,随时间的延长愈加明显 ,神经元坏死。凋亡细胞在 48～ 72 h达高峰 ,以后逐渐下降。脑胶质细胞出现增殖、肿胀、细胞突起增多、增粗。脑水肿、脑组织钙升高 ,镁则见下降。尼莫地平治疗可减轻脑组织水肿 ,脑组织钙含量下降 ,凋亡细胞减少。β-七叶甙钠亦可使脑水肿减轻 ,凋亡细胞减少 ,两种药物对镁均无影响。结论 弥漫性脑损伤后 ,轴索损害以继发为主。神经元的损伤不仅表现有细胞坏死 ,也表现有细胞凋亡和脑水肿、钙、镁及热休克蛋白等变化 ,说明脑损伤后存在一系列的继发性变化。尼莫地平及 β-七叶皂甙钠对弥漫性脑损伤具有一定的?

To study the pathogenesis of diffuse brain injury and observe the therapeutic effect of nimodipine and reparil on it.Methods The animal model of closed brain injury established by marmarou was adopted and the dynamic change of the neuron,axon,myelin sheath and glial cells were observed with the methods of immunohistochemistry,in situ end labelling,electrical microscope,together with conventional staining and special staining.The wistar rats were divided into two groups,nimodipine and reparil group.After the brain injury,nimodipine(2mg/kg) and reparil (4mg/kg) were injected via peritoneum respectively.At the time of 24,48,72 hours,the rats were sacrificed by decapitation.The content of brain water,calcium,magnesium,and the number of apoptotic cells were compared between the two groups in order to verify the therapeutic effect of two drugs.Results After the diffuse brain injury,the distortion of axon and myelin sheath were seen and became more obviously with the lapse of time.Nural necrosis and apoptotic cells reached their peak values at 48~72 hours and from then on descreased gradually.The glial cells proliferated,swelled,with more process of the cells.Brain edema occurred and calcium level in brain tissue rose after injury,while magnesium level declined.In the nimodipine group and reprail group,the content of brain water, calcium level and the number of apoptotic cell is lower,while the difference of the magnesium content is not significant.Conclusions After the diffuse brain injury,axotomy is mainly secondary.Neural apoptosis coexist necrosis,and the changes of water content,calcium,magnesium level show that there are a series of secondary changes after diffuse brain injury.Reprail and nimodipine have the therapeutic effect on diffuse head injury.