高压氧联合神经干细胞移植对脊髓损伤大鼠功能恢复的影响

Effects of hyperbaric oxygen combined with neural stem cell transplantation on functional recovery after spinal cord injury

目的观察神经干细胞（NSCs）移植联合高压氧（HBO）治疗对脊髓损伤（SCI）大鼠功能恢复的影响。方法共选取40只成年健康SD大鼠，采用随机数字表法将其分为假手术组、脊髓损伤组（SCI组）、神经干细胞移植组（NSCs组）及高压氧联合神经干细胞移植组（HBO＋NSCs组）。将上述各组大鼠制成脊髓全横断损伤模型，NSCs组及HBO＋NSCs组于术后分别给予NSCs移植治疗，HBO＋NSCs组大鼠在此基础上辅以HBO治疗。于制模后不同时间点采用斜板实验、BBB评分对各组大鼠进行运动功能评定，同时采用运动诱发电位（MEP）评估各组大鼠神经传导功能，并观察各组大鼠脊髓损伤处移植NSCs存活情况。结果从脊髓损伤后第2周开始，HBO＋NSCs组大鼠斜板实验和BBB评分结果均显著优于SCI组及NSCs组（P〈0．05）。在脊髓损伤后第4周时，SCI组仍无法引出MEP，而HBO＋NSCs组及NSCs组MEP波形均有所恢复，并且HBO＋NSCs组潜伏期较NSCs组显著缩短（P〈0．05）；同时HBO＋NSCs组受损脊髓存活的NSCs数量显著多于NSCs组（P〈0．05）。结论HBO联合NSCs移植治疗SCI大鼠具有协同效应，能进一步促进SCI大鼠肢体运动功能及神经传导功能恢复，其治疗机制可能与HBO促进大鼠脊髓损伤处移植NSCs存活有关。

Objective To investigate the effects of hyperbaric oxygen （HBO） combined with neural stem cell （NSC） transplantation on functional recovery after spinal cord injury （SCI）. Methods Forty healthy adult Sprague-Dawley rats were randomly divided into a sham group, an SCI group, an NSC group and an HBO ＋ NSC group. In the latter three groups, complete spinal cord transection was performed at T10. The rats of the HBO ＋ NSC group were treated with HBO therapy after NSC transplantation. Hindlimb motor function was assessed with the Basso- Beattie-Bresnahan （BBB） scale and tilt table testing. Motor evoked potentials （MEPs） were measured to evaluate the rats＇ nerve conduction function. The amount of surviving transplanted NSCs at the injured site was counted using Hoechst dyeing. Results The average BBB scores and tilt table test results in the HBO ＋ NSCs group were significantly better than in the SCI and NSC groups from the 2nd week post-SCI. By the 4th week the average latency period and MEP amplitude in the HBO ＋ NSC group were significantly better than in the NSC group, while MEPs in the SCI group still had not re-appeared. The surviving amount of transplanted NSCs in the HBO ＋ NSC group was also significantly greater than in the NSC group. Conclusion HBO combined with NSC transplantation has synergistic effects and can improve functional recovery after SCi. This may be explained by the important role of HBO in promoting the survival of transplanted NSCs.