中国神经再生研究(英文版)

中国神经再生研究(英文版) ›› 2019, Vol. 14 ›› Issue (5): 886-895.doi: 10.4103/1673-5374.249237

• 原著:脊髓损伤修复保护与再生 • 上一篇    下一篇

脊髓损伤72 h内髓内压的动态变化

  

  • 出版日期:2019-05-15 发布日期:2019-05-15
  • 基金资助:

    国家自然科学基金(81272164)；中国中央公共研究院基础科学研究专项基金(2016CZ-4，2018CZ-1)；北京脑疾病研究所基金(0000-100031)；中国康复研究中心基础科研基金(2017ZX-22，2017ZX-20)

Dynamic changes in intramedullary pressure 72 hours after spinal cord injury

Xin Zhang 1, 2, 3, 4, 5 , Chang-Bin Liu 1, 2, 3, 4, 5 , De-Gang Yang 1, 2, 3, 4, 5 , Chuan Qin 1, 2, 3, 4, 5 , Xue-Chao Dong 1, 2, 3, 4, 5 , Da-Peng Li 1, 2, 3, 4, 5 , Chao Zhang 1, 2, 3, 4, 5 , Yun Guo 1, 2, 3, 4, 5 , Liang-Jie Du 1, 2, 3, 4, 5 , Feng Gao 1, 2, 3, 4, 5 , Ming-Liang Yang 1, 2, 3, 4, 5 , Jian-Jun Li 1, 2, 3, 4, 5   

  1. 1 School of Rehabilitation Medicine, Capital Medical University, Beijing, China
    2 Department of Spinal and Neural Function Reconstruction, China Rehabilitation Research Center, Beijing, China
    3 Center of Neural Injury and Repair, Beijing Institute for Brain Disorders, Beijing, China
    4 China Rehabilitation Science Institute, Beijing, China
    5 Beijing Key Laboratory of Neural Injury and Rehabilitation, Beijing, China
  • Online:2019-05-15 Published:2019-05-15
  • Contact: Jian-Jun Li, 13718331416@163.com; Ming-Liang Yang, PhD, chinayml3@163.com.
  • Supported by:

    This study was supported by the National Natural Science Foundation of China, No. 81272164 (to JJL); the Special Fund for Basic Scientific Research of Central Public Research Institutes in China, No. 2016CZ-4 (to JJL), 2018CZ-1 (to JJL); the Beijing Institute for Brain Disorders in China, No. 0000-100031 (to JJL); the Basic Scientific Research Foundation of China Rehabilitation Research Center, No. 2017ZX-22,  2017ZX-20 (to JJL).

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摘要：

脊髓损伤后髓内压升高可能是影响脊髓继发性损伤的一个重要因素，然而目前尚缺乏脊髓损伤后髓内压的动态变化研究。为观察脊髓损伤72 h内髓内压的变化规律，作此实验设计探索其病理机制，用中国北京金牧阳实验动物养殖有限责任公司提供的雌性日本大耳兔，在T10处以动脉瘤夹造成脊髓损伤，建立脊髓损伤兔模型。(1)由于遥测系统测量髓内压具有一定侵入性，为验证该方法的可行性，首先分别在遥测压力探针插入脊髓的3个不同角度(30°，45°，90°)下测量髓内压，并测量了探针插入脊髓10 h内的脊髓水含量；(2)随后用遥测系统分别在动物麻醉和清醒状态下监测髓内压，脊髓损伤后动物清醒状态下72 h内髓内压的动态变化过程分为3个时期：急剧上升期(损伤后1-7 h)、缓慢上升期(损伤后8-38 h)、缓降期(损伤后39-72 h)；(3)实验根据脊髓内压力的变化规律选取时间点，评估了动物在脊髓损伤后72 h内的血脊髓屏障通透性、水肿、出血和组织学结果，发现脊髓损伤72 h内，脊髓出血在1 h时最为严重，随后逐渐降低；白蛋白和AQP4免疫反应性均先升高后降低，38 h达到峰值；(4)上述结果证实，脊髓组织严重出血是脊髓损伤早期髓内压急剧上升的主要原因，脊髓水肿和血脊髓屏障破坏是影响脊髓内压缓慢上升和缓慢下降的重要因素。

orcid: 0000-0003-2663-5971 (Jian-Jun Li)
           0000-0002-1068-0965 (Ming-Liang Yang)

关键词: 脊髓继发性损伤, 遥测, 病理机制, 兔, 清醒, 麻醉, 出血, 水肿, 压力测量, 血脊髓屏障, 神经再生

Abstract:

Intramedullary pressure increases after spinal cord injury, and this can be an important factor for secondary spinal cord injury. Until now there have been no studies of the dynamic changes of intramedullary pressure after spinal cord injury. In this study, telemetry systems were used to observe changes in intramedullary pressure in the 72 hours following spinal cord injury to explore its pathological mechanisms. Spinal cord injury was induced using an aneurysm clip at T10 of the spinal cord of 30 Japanese white rabbits, while another 32 animals were only subjected to laminectomy. The feasibility of this measurement was assessed. Intramedullary pressure was monitored in anesthe¬tized and conscious animals. The dynamic changes of intramedullary pressure after spinal cord injury were divided into three stages: stage I (steep rise) 1–7 hours, stage II (steady rise) 8–38 hours, and stage III (descending) 39–72 hours. Blood-spinal barrier permeability, edema, hemorrhage, and histological results in the 72 hours following spinal cord injury were evaluated according to intramedullary pressure changes. We found that spinal cord hemorrhage was most severe at 1 hour post-spinal cord injury and then gradually decreased; albumin and aquaporin 4 immunoreactivities first increased and then decreased, peaking at 38 hours. These results confirm that severe bleeding in spinal cord tissue is the main cause of the sharp increase in intramedullary pressure in early spinal cord injury. Spinal cord edema and blood-spinal barrier destruction are important factors influencing intramedullary pressure in stages II and III of spinal cord injury.

Key words: nerve regeneration, secondary spinal cord injury, telemetry, pathological mechanism, rabbit, conscious, anesthetized, hemorrhage, edema, pressure measurement, blood-spinal barrier, neural regeneration