高压氧联合骨髓间充质干细胞治疗创伤性脑损伤大鼠的疗效观察

目的 观察高压氧联合骨髓间充质干细胞（BMSCs）对创伤性脑损伤（TBI）的治疗效果。 方法 采用随机数字法将80只TBI大鼠分为对照组、高压氧治疗组（高压氧组）、干细胞移植组（干细胞组）、干细胞移植+高压氧治疗组（联合组）,每组20只。对照组造模成功后不接受治疗;干细胞组于造模成功24 h后进行干细胞移植;高压氧组于造模成功24 h后接受高压氧治疗;联合组于造模成功24 h后先进行干细胞移植,移植完成1 h后即接受高压氧治疗。4组大鼠均于造模成功后和取材前进行神经功能缺失评分（NSS）,并于对应的取材时间点取脑组织行苏木精-伊红（HE）染色,并于光镜下计算免疫组化检测核因子-kB（NF-kB）、脑源性神经营养因子（BDNF）表达。 结果 造模后第3、5、10、20天,均以联合组的NSS评分最低,与其余3组同时间点比较,差异均有统计学意义（P<0.05）;造模后第20天,联合组的NSS评分为（1.8±0.45）分,显著优于组内造模后第3、5天,差异均有统计学意义（P<0.05）。高压氧组、干细胞组、联合组的脑细胞水肿程度均较对照组轻,炎症细胞浸润少。造模后第3、5、10、20天,联合组脑组织中NF-kB和BDNF的阳性细胞数均高于其余3组同时间点,差异均有统计学意义（P<0.05）。 结论 高压氧联合BMSCs可显著改善TBI大鼠神经神经功能障碍程度,减轻损伤区和周围组织的炎症和水肿,促进NF-kB和BDNF的表达,且以长疗程的高压氧治疗疗效更佳。

Using hyperbaric oxygen with mesenchymal stem cells to treat traumatic brain injury

Objective To investigate any therapeutic effect of combining hyperbaric oxygen with mesenchymal stem cells (MSCs) in treating traumatic brain injury (TBI). Methods Eighty healthy adult rats were randomly divided into a control group, a hyperbaric oxygen group, a stem cell group and a combination group, each of 20. TBI was introduced into the rats of all 4 groups. Twenty-four hours after the modelling, the hyperbaric oxygen group received hyperbaric oxygen therapy, the stem cell group received MSCs transplantation, the combination group was given the hyperbaric oxygen therapy an hour after the MSCs transplantation, while the control group was not given any treatment. All of the rats were evaluated using neurological severity scores (NSSs) after the modeling and again after the treatment. They were then sacrificed for HE staining and the expression of nuclear factor kappa B (NF-kB) and brain-derived neurotrophic factor (BDNF) were observed. Results On the 3rd, 5th, 10th and 20th day after the modeling, the average NSS of the combination group was significantly lower than those of the other three groups. However, the average NSS of the combination group on the 20th day was significantly superior to that on the 3rd and the 5th days. Compared with the control group, the edema of brain cells was less severe in the other 3 groups. The average expression of NF-kB and BDNF in the combination group was significantly higher than in the other 3 groups on the 3rd, 5th, 10th and 20th day after the modeling. Conclusion Hyperbaric oxygen, especially long term treatment combined with stem cell transplantation, can significantly improve nerve function in the brain after trauma, relieve inflammation and edema in and around the damaged area, and promote the expression of the NF-kB and BDNF.