脑损伤后不同时间给予高渗盐-羟乙基淀粉液的治疗效应

目的探讨在创伤性脑损伤后不同时间给予高渗盐-羟乙基淀粉液(HSH)对脑损伤的影响。方法选用SD大鼠64只,采用Feeney自由落体损伤模型,于伤后早期(伤后10min)和后期(伤后6h)分别经尾静脉注射HSH、生理盐水(4mg/kg),并据此分为四组,24h后处死动物,干湿重法测定脑组织含水量,伊文氏兰(EB)测定对血脑屏障的影响及应用流式细胞仪测定各组对损伤区周围皮质调亡的影响。结果伤后10minHSH10组的脑组织含水量和EB含量略高于NS10组,而皮层脑细胞调亡数明显低于NS10组(P<0.05);伤后6hHSH6组的脑组织含水量、EB含量和皮层脑细胞调亡数均明显低于NS6组(P<0.05);HSH6组的脑组织含水量、EB含量和皮层脑细胞调亡数均明显低于HSH10组(P<0.05)。结论脑损伤早期给予HSH会加重脑水肿,伤后6h给予HSH不会加重脑水肿;无论伤后早期还是晚期给予HSH均可减少皮层脑细胞调亡数,晚期给药效果更佳。

Therapeutic efficacy of hypertonic sodium chloride-hydroxyethyl starch-40 injection (HSH) infused at different times on traumatic brain injury

Objective To compare the effects of hypertonic sodium chloride-hydroxyethyl starch-40(HSH)administered at different times after isolated traumatic brain injury.Methods The brain injury was induced using Feeney's 'freefall' model of traumatic brain injury.Male SD rats were randomized to two groups of receiving HSH and hypertonic sodium chloride(HS)(4ml/kg)at 10min(group HSH10 and group NS10)or 6h(group HSH6 and group NS6)after traumatic brain injury.All animals were sacrificed at 24h after injury.The water content of the injured hemispheres and EB content in the injured areas were measured.The extent of apoptotic cells was analyzed by FCM.ResultsWater content and EB content were slightly larger in group HSH10 than those in group NS10,but the extent of apoptotic cell of the injured hemispheres was less in group HSH10 than that in group NS10(P<0.05).Water content and EB content as well as the extent of apoptotic cell of the injure hemispheres were significantly less in group HSH6 than those in group NS6(P<0.05).Conclusion Brain edema is worsened when HSH is administered at early stage(10min)after injury,which is not when given in later stage(6h)after injury,but the extent of apoptotic cell may be decreased whenever,especially in the later stage,HSH is infused after brain injury in rats.