早期不同压力高压氧治疗中重度创伤性脑损伤大鼠的疗效及磁共振变化特点

目的:探讨早期不同压力高压氧(HBO)治疗中重度创伤性脑损伤(TBI)大鼠的疗效及磁共振变化特点。方法:健康清洁级成年雄性SD大鼠60只,采用随机数字表法分为TBI组、假手术组(Sham组,仅将颅骨开窗,不予头部打击)、0.15 MPa HBO组(在TBI组的基础上给予0.15 MPa HBO治疗)、0.25 MPa HBO组(在TBI组的基础上给予0.25 MPa HBO治疗),每组15只。所有大鼠分别在术后第1天(D1)、第3天(D3)、第7天(D7)进行神经功能缺损评分(mNSS);在磁共振DWI图像上显示高信号处取3个感兴趣区(ROI),测量各点表观弥散系数(ADC),比较病变侧与正常对侧ADC的比值,即相对ADC(rADC)。结果:在D1,各组大鼠不同ROI的rADC值比较差异均无统计学意义( P>0.05);在D3,0.15 MPa和0.25 MPa HBO组不同ROI的rADC值均低于TBI组( P<0.05),高于Sham组( P<0.05),0.15 MPa和0.25 MPa HBO组间比较差异无统计学意义( P>0.05);在D7,0.15 MPa和0.25 MPa HBO组rADC值均低于TBI组( P<0.05),与Sham组比较差异无统计学意义( P>0.05),0.15 MPa和0.25 MPa HBO组间比较差异无统计学意义( P>0.05);在D1,TBI组、0.15 MPa和0.25 MPa HBO组大鼠mNSS差异无统计学意义( P>0.05),但均显著高于sham组( P<0.05);在D3,0.15 MPa和0.25 MPa HBO组mNSS均低于TBI组( P<0.05),高于Sham组( P<0.05), 0.15 MPa和0.25 MPa HBO组间比较差异无统计学意义( P>0.05);在D7,0.15 MPa和0.25 MPa HBO组mNSS均低于TBI组( P<0.05),略高于Sham组( P>0.05)。 结论:早期HBO治疗中重型TBI大鼠疗效确切,但HBO的治疗压力可能不是决定预后的关键环节。

Magnetic resonance imaging changes and curative effects of early different pressure hyperbaric oxygen on moderate and severe traumatic brain injury in rats

Objective To investigate the characteristics of magnetic resonance imaging changes and the curative effects of early different pressure hyperbaric oxygen(HBO)on moderate and severe traumatic brain injury in rats.Methods Sixty healthy clean male adult Sprague-Dawle rats were randomly divided into four groups by random number table:traumatic brain injury group(TBI group),sham operation group(sham group.Only opening the skull,but no head strike),0.15 MPa HBO group(giving 0.15 MPa HBO to TBI rats),and 0.25 MPa HBO group(giving 0.25 MPa HBO to TBI rats).Each group has 15 rats.All rats were subjected to modified neurological severity score(mNSS)evaluation and MRI examination on day 1(D1),day 3(D3),and day 7(D7)respectively.Three regions of interest(ROI)were taken from the high-signal regions of the magnetic resonance DWI image.The apparent diffusion coefficient(ADC)of each region was measured.The ratios of the ADC of the lesion side to the ADC of the normal contralateral side,i.e.the relative ADC(rADC),were compared.Results(1)On D1,all the rADC values of ROIs in each group were not statistically significant(P>0.05).On D3,the rADC values of different ROIs in 0.15 MPa HBO and 0.25 MPa HBO groups were all lower than those in TBI group(P<0.05),but all higher than sham group(P<0.05);there was no significant difference between 0.15 MPa HBO and 0.25 MPa HBO groups(P>0.05).On D7,the rADC values of different ROIs in 0.15 MPa HBO and 0.25 MPa HBO groups were all lower than those of TBI group(P<0.05);there was no significant difference when those compared with sham group(P>0.05),and there was no significant difference between 0.15 MPa HBO and 0.25 MPa HBO groups(P>0.05).(2)On D1,there was no significant difference in mNSS scores among TBI group,0.15 MPa HBO group and 0.25 MPa HBO group(P>0.05),but the mNSS scores of TBI group,0.15 MPa HBO group and 0.25 MPa HBO group were all significantly higher than that of sham group(P<0.05).On D3,the mNSS scores of 0.15 MPa HBO and 0.25 MPa HBO groups were all lower than that of TBI group(P<0.05),but all higher than that of sham group(P<0.05);there was no significant difference between 0.15 MPa HBO group and 0.25 MPa HBO group(P>0.05).On D7,the scores of mNSS in 0.15 MPa HBO and 0.25 MPa HBO groups were all lower than that in TBI group(P<0.05),but all slightly higher than that in sham group(P>0.05).Conclusion There is definite curative effect of early HBO on moderate and severe TBI,but the pressure of HBO may not be the key factor in determining prognosis.