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1.
[目的]探讨大鼠急性颈脊髓损伤后不同时间节点血清及肺泡灌洗液中CD44含量的变化与肺水肿的关系.[方法]成年Wistar大鼠40只,体重240 ~ 250 g,雌雄不限.大鼠随机分为实验组和对照组,每组20只,每组又分为造模后24 h、3d、1、2周共4个时间点,每个时间点5只大鼠.实验组采用C7段脊髓改良Allen’s打击法制作大鼠脊髓损伤模型,打击力度为10×2.5 g·cm;对照组只暴露C7脊髓.在不同时间点处死大鼠,检测各时间点两组大鼠血清和肺泡灌洗液中CD44含量和蛋白浓度,计算肺通透指数.[结果]急性脊髓损伤大鼠伤后肺泡灌洗液的CD44无明显变化,血清CD44含量于伤后24 h开始下降,伤后3d达最低值,伤后1周含量开始回升,伤后24 h和3d实验组大鼠血清CD44含量与假手术组有显著差异性.CD44含量变化周期与SCI后肺水肿及肺病理变化周期呈负相关.[结论]血清CD44含量变化周期与SCI后肺水肿及肺病理变化周期呈负相关,急性脊髓损伤后肺水肿的形成过程可能与SCI后血清CD44含量下降有关.  相似文献   

2.
目的 :探讨大鼠急性颈脊髓损伤后P物质与肺水肿的关系。方法 :成年Wistar大鼠40只,体重240~250g,雌雄不限,随机分为实验组和对照组,每组20只,每组又分为造模后24h、3d、1周、2周共4个时间点,每个时间点5只大鼠。实验组采用改良Allen′s打击法制作大鼠C7急性脊髓损伤(SCI)模型,打击力度为10×2.5g.cm;对照组只暴露C7段脊髓。在造模后相应时间点处死大鼠,通过光学显微镜观察肺组织的病理学变化,并检测各时间点两组大鼠血清和肺泡灌洗液中P物质含量和蛋白浓度,计算肺通透指数(肺泡灌洗液蛋白浓度/血清蛋白浓度)。结果:实验组大鼠急性SCI后24h肺组织可见肺毛细血管充血,肺泡内分泌物增多、红细胞增加;伤后3d达到高峰;伤后1周肺泡内水肿、出血较3d时减轻;伤后2周明显好转;对照组肺泡透亮,无水肿和出血。实验组伤后24h血清和肺泡灌洗液中P物质升高,伤后3d达高峰,伤后1周开始下降,伤后2周明显下降;实验组伤后24h、3d、1周血清及伤后24h、3d肺泡灌洗液中P物质含量与对照组比较有显著性差异(P<0.05),伤后2周两组比较无显著性差异(P>0.05)。肺通透指数的变化与P物质的变化趋势相同。结论:大鼠急性颈SCI后肺泡灌洗液及血清中P物质含量变化与肺水肿程度变化同步,P物质可能参与了急性颈SCI后肺水肿的形成过程。  相似文献   

3.
目的研究并探讨传统中药黄芪对大鼠急性脊髓损伤(spinal cord injury,SCI)细胞免疫调节作用的影响,为其在SCI治疗中的应用提供理论依据。方法SD大鼠48只随机分为4组,每组12只。其中1组为正常对照组,另外3组为脊髓损伤组,采用改良Allen's法建立大鼠脊髓损伤模型,随机分为(1)SCI未治疗组;(2)SCI注射生理盐水组(简称SCI+SAL组);(3)SCI注射黄芪注射液组(简称SCI+HQ组)。正常对照组和SCI未治疗组未予以任何药物治疗,SCI+SAL组和SCI+HQ组分别在大鼠急性脊髓损伤后12 h、36 h、5~9 d注射生理盐水和黄芪注射液,并用流式细胞仪检测大鼠外周血T淋巴细胞表型CD4和CD8的表达水平。观察胸腺和脾脏的外观形态改变、重量变化及其组织病理学变化。结果 SCI+HQ组的大鼠伤后36 h外周血T淋巴细胞CD4值较12 h升高,至伤后第5天CD4值明显高于SCI未治疗组(P〈0.01),与SCI+SAL组相比,虽无统计学差异,但有明显高于SCI+SAL组的趋势。伤后5~8 d继续采用黄芪注射液治疗,至伤后第9天,SCI+HQ组的CD4值明显低于正常对照组(P〈0.05)。停用黄芪注射液,至伤后第14天,SCI+HQ组的CD4值又逐渐恢复,与正常对照组无统计学差异。SCI+HQ组的胸腺重量及其占体重的百分比均明显高于SCI+HQ组(P〈0.01及P〈0.05)。结论黄芪可促使脊髓损伤后外周血T淋巴细胞的CD4值明显升高,对细胞反应低下有显著提高作用,可作为一种免疫增强调节剂纠正免疫反应低下状态;而过大剂量的黄芪也可能是种免疫抑制剂,抑制大鼠的细胞免疫反应。  相似文献   

4.
异氟烷对大鼠急性脊髓损伤后神经源性肺水肿的影响   总被引:1,自引:0,他引:1  
[目的]探讨吸入异氟烷的大鼠急性脊髓损伤过程中血流动力学变化及损伤后肺组织的病理改变.[方法]成年雄性SD大鼠60只,体重280~330 g,随机分为水合氯醛组、1.5%异氟烷组和3%异氟烷组.在T8水平球囊扩张造成脊髓压迫,术中监测大鼠的血压、心率,压迫结束10 min后处死大鼠,取肺组织称湿、干重,计算湿干重之比;通过大体解剖和光学显微镜观察肺组织的病理变化.[结果]所有进行脊髓压迫的大鼠血压均高于术前基础值(P<0.05),心率均低于术前基础值(P<0.05),1.5%异氟烷组在脊髓压迫过程中的血压上升明显高于水合氯醛组和3%异氟烷组(P<0.05),心率较基础值下降则大于水合氯醛组和3%异氟烷组(P<0.05),水合氯醛组与3%异氟烷组的血压、心率变化差异不显著(P>0.05);1.5%异氟烷组大鼠肺水肿程度较重,肺的湿干重之比较水合氯醛组、3%异氟烷组高,有显著差异(P<0.05),水合氯醛组与3%异氟烷组差异不显著(P>0.05).[结论]使用1.5%异氟烷麻醉的大鼠急性脊髓损伤后肺水肿的发生速度快、严重程度高,可能与难以抑制交感神经的过度兴奋有关,因此在临床上应尽量避免单纯长时间吸入1.5%异氟烷,以防病人术后肺水肿的发生.  相似文献   

5.
大鼠脊髓损伤后兴奋性氨基酸的变化及其对血流量的影响   总被引:4,自引:1,他引:4  
采用Allen's打击法复制大鼠脊髓损伤(SCI)模型,氨基酸微量检测技术和氢清除法分别测定伤段脊髓组织24h内兴奋性氨基酸(EAA)即谷氨酸(Glu)、天冬氨酸(Asp)含量和脊髓灰质血流量(SCBF)的变化,并观察脊髓蛛网膜下腔注射EAA受体激动剂N-甲基-D-天冬氨酸(NMDA)对SCBF的影响,探讨EAA在SCI中的作用。结果发现:SCBF在伤后10min即有明显下降,2h较1h略有回升,4~8h又进一步下降,第二次下降与第一次下降相差显著。伤后脊髓蛛网膜下腔注射NMDA明显加剧SCI后脊髓缺血。Glu、Asp伤后10min均明显升高,1~24hAsp较对照组明显降低,8h较2h略有回升;Glu在伤后10min有所下降,但仍高于对照组,4h、8h较2h略增加。EAA变化与SCBF呈显著负相关。结果提示SCI后EAA的过度释放是SCI后继发损伤的重要因素。  相似文献   

6.
中药黄芪对实验性脊髓损伤的神经保护作用   总被引:12,自引:0,他引:12       下载免费PDF全文
目的探讨黄芪(AR)对脊髓继发性损伤的保护作用,并与甲基强地松龙(MP)进行对照.方法 Wistar大鼠60只,以改良Allen氏法制备脊髓打击伤模型,随机分为三组.测定不同药物处理后4 h、8 h、24 h脊髓组织线粒体SOD活性和MDA浓度以及血液流变学改变;光镜观察用药后1、2周黄芪对病理学改变的影响,同时进行联合行为学评分(CBS).结果黄芪处理后脊髓组织MDA浓度明显低于各时相点对照组,SOD活性显著升高(P<0.01),与MP治疗组无明显差异(P>0.05).血液流变学指标也有所改善.病理检查发现黄芪治疗组髓鞘受损轻微,组织赦免范围增大.结论黄芪治疗可以缓解脊髓损伤后的脂质过氧化反应,改善微循环,从而发挥脊髓保护作用.  相似文献   

7.
目的 研究异丙酚对大鼠急性脊髓损伤的影响.方法 雌性SD大鼠60只,体重230~270 g,随机分为3组(n=20):假手术组、脊髓损伤组和异丙酚组.采用改良的Allen打击法致伤大鼠脊髓,打击后30 min,异丙酚组经尾静脉持续输注1%异丙酚60 mg·lg-1·h-1 1 h,其余2组持续输注0.9%生理盐水6 ml·kg-1·h-1 1 h.应用斜板实验评分法和BBB联合评分法评价后肢运动功能;采用原位末端标记法(TUNEL法)检测脊髓组织细胞凋亡;HE染色后光镜下观察脊髓组织病理学.结果 异丙酚组行为学评分高于脊髓损伤组(P<0.05);与假手术组相比,脊髓损伤组各时点单位面积凋亡细胞数均升高(P<0.01);与脊髓损伤组相比,异丙酚组各时点单位面积凋亡细胞数均降低(P<0.05);脊髓损伤组脊髓病理损伤较异丙酚组重,可见大量神经元坏死.结论 持续静脉输注1%异丙酚60 mg·kg-1·h-1 h可减轻大鼠急性脊髓损伤,其机制与抑制细胞凋亡有关.  相似文献   

8.
探讨神经生长因子(NGF)对脊髓损伤保护作用的机制。方法采用Alien’s法以25gcm致伤大鼠T8脊髓,经蛛网膜下腔导管分别于术后即刻、30分钟、1、2、3、4、8、12、24小时各注入NGF溶液,并与生理盐水组和正常对照组作对照。采用放射强度测定法测定一氧化氮合成酶(NOS)含量。结果与正常组相比较,NOS含量在伤后10分钟、1、2、4、8小时均显著升高(P<0.01),NGF治疗组与生理盐水组相比较,在伤后10分钟、1、2、4、8小时NOS活性明显下降(P<0.01)。结论NGF通过抑制脊髓损伤后NOS的升高效应,抑制了一氧化氮(NO)的神经毒性作用,从而保护了神经组织。  相似文献   

9.
C9、CD59在大鼠急性脊髓损伤组织中的表达   总被引:3,自引:2,他引:3  
目的探讨补体系统固有成分C9及补体调节因子CD59在大鼠急性脊髓损伤组织中的表达。方法采用改良Allen重物打击法制成SD大鼠脊髓急性损伤模型,观察各组伤后12h、1、3、5、7d各时间点脊髓损伤组织的变性坏死、中性粒细胞浸润情况及C9、CD59阳性反应物的表达部位及时程。结果伤后12h损伤组织中开始有C9、CD59阳性表达,在伤后3d达到高峰,之后表达逐渐减少,伤后1周趋于稳定,随时间延长存在动态变化过程,且与脊髓损伤组织的变性坏死、中性粒细胞浸润程度相一致。结论在急性脊髓损伤组织中有补体固有成分C9及补体调节因子CD59的表达,补体系统参与了继发性脊髓损伤。  相似文献   

10.
11.
[目的]探讨吸入异氟烷的大鼠急性脊髓损伤后血清和肺泡灌洗液中P物质含量的改变与神经源性肺水肿的关系.[方法]成年雄性SD大鼠30只,体重300~330 g,随机分为1.5%异氟烷组、水合氯醛组和假手术组,每组10只.在T8水平球囊扩张造成脊髓压迫,压迫结束10 min后处死大鼠.检测各组大鼠血清和肺泡灌洗液中P物质含量和蛋白浓度,计算肺通透指数.[结果]1.5%异氟烷组大鼠血清和肺泡灌洗液中P物质高于水合氯醛组(P<0.05),明显高于假手术组(P<0.01);肺通透指数1.5%异氟烷组也高于水合氯醛组和假手术组(P<0.05).水合氯醛组和假手术组的P物质及肺通透指数均没有明显差异(P>0.05).[结论]1.5%异氟烷可能通过刺激P物质的大量释放参与急性脊髓损伤后肺水肿的形成过程.  相似文献   

12.
Anesthetics can either promote or inhibit the development of neurogenic pulmonary edema (NPE) after central nervous system (CNS) injury. The influence of isoflurane was examined in male Wistar rats using 1.5%, 2%, 2.5%, 3%, 4%, or 5% isoflurane in air. Epidural balloon compression of the thoracic spinal cord was performed. The development of NPE was examined in vivo and on histologic sections of lung tissue. Animals anesthetized with 1.5% or 3% isoflurane were behaviorally monitored using the BBB and plantar tests for 7 weeks post-injury. The spinal cord was examined using MRI and morphometry of the spared white and gray matter. All animals from the 1.5% and 2% groups developed NPE. Almost 42% of the animals in the 1.5% group died of severe pulmonary hemorrhage and suffocation; x-rays, the pulmonary index, and the histological picture revealed a massive NPE. More than 71% of the animals from the 2.5% and 3% groups did not develop any signs of NPE. Blood pressure after spinal cord compression rose more in the 1.5% group than in the 3% one. In the 1.5% group, the sympathetic ganglionic blockade prevented the neurogenic pulmonary edema development. Animals from the 3% group recovered behaviorally more rapidly than did the animals from the 1.5% group; morphometry and MRI of the lesions showed no differences. Thus, low levels of isoflurane anesthesia promote NPE in rats with a compressed spinal cord and significantly complicates their recovery. The optimal concentration of anesthesia for performing a spinal cord compression lesion is 2.5-3% isoflurane in air.  相似文献   

13.
目的:评价在颈髓损伤后肺不张并感染患者中联合应用支气管肺泡灌洗与机械通气的效果.方法:将2005年6月~2008年5月我院42例颈髓损伤气管切开术后发生肺不张合并肺部感染的患者随机分为两组,每组21例,A组接受常规治疗(包括抗生素、化痰、湿化气道、拍背促进排痰、营养及支持治疗)及联合应用支气管肺泡灌洗(BAL)与呼吸机辅助通气治疗,B组仅行常规治疗,比较两组患者的治疗效果.结果:A组患者治愈12例,显效5例,好转2例,无效2例,有效率为90.5%;B组治愈8例,显效4例,好转3例,无效6例,有效率为71.4%.两组比较有显著性差异(P<0.01).A组患者抗感染时间为8.1±0.5d,B组为12.3±0.7d,两组比较有显著性差异(P<0.01).A组发生窒息和呼吸衰竭各1例(发生率为9.5%),B组分别为2例和4例(发生率为28.6%),两组发生率比较有显著性差异(P<0.01).B组1例因呼吸循环衰竭死亡.A组患者在BAL治疗过程中,3例血氧饱和度降至80%以下,经暂停操作、呼吸机辅助呼吸后恢复并完成冶疗;5例发生心动过速,3例发生心动过缓,无心跳骤停发生.结论:在颈髓损伤后肺不张并感染患者中联合应用支气管肺泡灌洗与机械通气可提高有效率.缩短治疗时间,减少窒息和呼吸衰竭的发生,改善预后.  相似文献   

14.
STUDY DESIGN: Prospective clinical trial. OBJECTIVES: To evaluate the efficacy of a specific protocol for prevention of thrombo-embolic disease occurring during the acute stage of spinal cord lesions, based on the simultaneous use of pharmacological plus mechanical procedures. SETTING: Regional Spinal Unit of Florence, Italy. INTRODUCTION: Deep venous thrombosis (DVT) is a dangerous pathology whose first clinical sign can be represented by unexpected pulmonary embolism (PE). Its incidence in acute spinal cord injured (SCI) patients is reported to range between 9% and 90%. Its prevention represents one of the major challenges for the clinicians involved in the care of such patients. METHOD: Two hundred and seventy-five SCI patients consecutively admitted to our Centre were investigated by colour doppler ultrasonography of lower limbs and pelvis on admission, after 30-45 days and whenever clinically requested. Subcutaneous Nadroparine, a low molecular weight heparin (LMWH), plus early mobilisation, permanently dressed gradient elastic stockings (PGES), and external sequential pneumatic compression (ESPC) of the lower limbs, applied during the first 30 days after injury, were given to all of them. Colour doppler ultrasonography (CDUS) complete investigations of the lower limbs and pelvis were performed on admission, after 30-45 days and whenever clinically requested. The patients were divided into two groups according to their time interval from injury to the admission to our Centre. RESULTS: The incidence of detected DVT was 2% in those patients (99) admitted early to our centre (within 72 h from the trauma), who immediately received our prophylactic protocol. No PE was reported. The other group of patients (176), all admitted between 8 and 28 days (mean 12 days) developed DVT in 26% of cases. None of these patients received ESPC before being admitted to our Centre. No patient had been admitted between 3 and 8 days interval time post injury. CONCLUSION: Early application of pharmacological plus mechanical treatment for DVT prevention produces a marked reduction in such complications. It also reduces the risks of morbidity and mortality in our patients, and, not least, reduces the hospitalization costs during the early period of rehabilitation.  相似文献   

15.
Li S  Tator CH 《Spinal cord》1999,37(12):820-832
OBJECTIVES: To determine whether MK801, an NMDA receptor antagonist, blocks glutamate excitotoxicity directly or via other mechanisms such as improving blood supply at the injury site in a rat model of spinal cord injury (SCI). In the present study, the effects of pre- and posttreatment with MK801 on axonal function, spinal cord blood flow (SCBF) and cord water content were studied after acute SCI in rats. METHODS: Somatosensory evoked potentials (SSEPs) and cerebellar evoked potentials (CEPs) were used to quantify electrophysiological function, and the hydrogen clearance technique and wet-dry weight measurements were used to measure SCBF and cord water content, respectively. Twenty rats received a 21 g clip compression injury of the cord at T1, and were then randomly and blindly allocated to either MK801 or saline groups. Each rat received an intravenous infusion of drug or saline four times during the experiment (16 min/infusion) with the first infusion (MK801 3 mg/kg) beginning 8 min pre-injury, and the other infusions (MK801 1. 5 mg/kg) at 1 h intervals after injury. Control experiments on uninjured rats were performed in 10 rats using the same procedure as above except the clip compression injury of the cord was omitted. RESULTS: In the MK801 groups with or without SCI, the amplitude of the evoked potential peaks, especially the SSEPs, was significantly lower than in the saline group. There were no differences in SCBF or cord water content between the MK801 and saline groups. CONCLUSION: Pre- and posttreatment with MK801 inhibits evoked potentials, but does not improve SCBF or cord edema after acute compression SCI in rats. For the first time it has been shown that MK801 produced a blockade of glutamate excitatory transmission in afferent pathways after SCI. Further work is required to determine whether this inhibition is reversible and related to neuroprotection and functional recovery after SCI.  相似文献   

16.
目的 探讨肺癌病人术前血清及支气管肺泡灌洗液(BALF)中内皮抑素(endostatin)表达情况,分析其与肿瘤临床病理特征和预后的关系.方法 酶联免疫吸附(ELISA)法检测57例肺癌及34例肺良性病变者术前血清及BALF中endostatin含量.结果 肺癌病人血清及BALF术前内皮抑素含量显著高于肺良性病变者,差异有统计学意义(P<0.05).淋巴结及远处转移组术前内皮抑素含量明显高于无转移组(P<0.05);肺腺癌病人外周血清及BALF中内皮抑素表达高于鳞癌、小细胞癌者;Ⅲ~Ⅳ期病人血清、BALF内皮抑素水平高于Ⅰ~Ⅱ期者(P<0.01).肺癌病人内皮抑素在外周血清及BALF中的表达呈线性正相关(P=0.000).结论 肺癌病人血清及支气管肺泡灌洗液中内皮抑素含量明显高于良性病变者,且与肿瘤组织学类型、分化程度、TNM分期、淋巴结转移呈明显正相关,肺泡灌洗液中内皮抑素含量较血清中高且更敏感,可能有助于肺癌病人预后的评估及肿瘤分化程度判断.  相似文献   

17.
目的:探讨急性颈脊髓损伤患者肺部感染的危险因素与病原菌分布特点及耐药性。方法:2010年1月~2014年12月收治急性颈脊髓损伤患者527例,发生肺部感染83例,应用Logistic回归方法分析肺部感染与颈脊髓损伤部位(C1~C4为高位损伤,C5~C7为低位损伤)、ASIA分级、气管切开及机械通气的相关性,并分析肺部感染患者痰细菌培养的细菌种类、株数及耐药率。结果:ASIA分级A级患者158例(30.0%),其中高位损伤43例(8.2%),均行气管切开、呼吸机辅助呼吸,发生肺部感染39例(90.7%);低位损伤115例(21.8%),52例行气管切开,21例行呼吸机辅助呼吸患者中肺部感染16例(76.2%),31例未行呼吸机辅助呼吸患者中肺部感染7例(22.6%)。B级103例(19.5%),其中高位损伤27例(5.1%),19例气管切开、呼吸机辅助呼吸,肺部感染12例(63.2%);低位损伤76例(14.4%),27例气管切开,18例呼吸机辅助呼吸患者中肺部感染2例(11.1%),9例未行呼吸机辅助呼吸患者未发生肺部感染。C级83例、D级183例,均未行气管切开及呼吸机辅助呼吸,均未发生肺部感染。Logistic回归分析显示高位颈髓损伤、ASIA A级损伤及机械通气均是急性颈脊髓损伤患者肺部感染发生的危险因素(P≤0.001),气管切开对肺部感染的发生率无显著性影响(P=0.07)。83例肺部感染患者痰标本培养出细菌117株,其中多重耐药菌75株(64.1%);其中非发酵G-菌(铜绿假单胞菌、洛菲不动杆菌、鲍曼不动杆菌、嗜麦芽窄食单胞菌、臭鼻克雷伯菌、液化沙雷菌、苯丙酮酸莫拉菌、产碱假单胞菌)76株(65.0%),其中59株(77.6%)多重耐药;金黄色葡萄球菌23株(13.8%),其中耐甲氧西林金黄色葡萄球菌(MRSA)7株(30.4%);肠杆菌(产气肠杆菌、阴沟肠杆菌)12株(10.3%),其中5株(41.7%)多重耐药。结论:高位、完全性颈髓损伤及机械通气是急性颈脊髓损伤患者肺部感染发生的相关危险因素,肺部感染的病原菌主要是多重耐药非发酵G-菌,MRSA及多重耐药肠杆菌亦占有一定比例。  相似文献   

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