高渗盐水对脊髓继发性损伤的影响

Effect of hypertonic saline on secondary spinal cord injury in rats

目的 探讨高渗盐水对脊髓继发性损伤机制的影响 ,以及对脊髓急性损伤后神经功能恢复的作用。方法 36只SD大鼠造成T10节段脊髓急性压迫损伤后 ,随机分为 3组 :高渗盐水治疗组、生理盐水治疗组及对照组 ,每组观察损伤后 1周、损伤后 4周两时间段 ;评价动物神经功能 ,观察各时间段组织病理改变 ,计算脊髓残留组织保留率。结果 (1)于损伤后 1周 ,高渗盐水治疗组脊髓组织水肿、炎症反应明显减轻 :(2 )于损伤后 4周 ,高渗盐水治疗组脊髓残留组织保留率显著增加 ,与其它两组有显著性差异(P <0 0 1) ;(3)高渗盐水 ,治疗组动物神经功能恢复更快、更完全 ,与生理盐水治疗组及对照组相比有显著性差异 (P <0 0 5 )。结论 高渗盐水能减轻损伤后脊髓组织的水肿及炎症反应 ,改善组织低灌注 ,从而阻止脊髓组织进一步变性、坏死 ,促进神经功能恢复。

Objective To observe the effects of hypertonic saline on the mechanisms of secondary spinal cord injury ,and investigate its effect on neurological recovery.Methods 36 SD rats were randomized into three groups after experiencing acute spinal cord compression at the level of T10:the hypertonic saline treated group,normal saline treated group and control group. The observation periody in each group included 1-week post-injury and 4-week post-injury. All animals were sacrificed after evaluating the neurological function at the end of the observation period.T9～T11 spinal cords were removed after perfusion fixation, the tissue was sectioned at 10μ and stained with HE and toluidine blue. Finally, we observed the pathological changes of spinal cord at each observing period and measured the spared tissue area of spinal cord at 4-week post-injury.Results The edema and inflammation of spinal cord in hypertonic saline treated group was less than that in the other two at 1-week post-injury. The area of spinal cord increased significantly in hypertonic saline treated group at 4-week post-injury(P<0.01). Accordingly, there was significantly better neurological recovery in the hypertonic saline treated group than in the others(P<0.05).Conclusion These results strongly suggest that hypertonic saline exerts its effect on spinal cord injury. Alleviating edema and inflammation, and increasing blood flow of spinal cord after spinal cord injury are the possible mechanisms of this effect.