摘要
目的:探讨大剂量高压氧(HBO)治疗急性脑卒中的疗效及机制。方法:以大鼠大脑中动脉永久性阻塞模型为对象;以神经功能评分和梗死容积为指标,对9和18h两种HBO方案超早期治疗急性缺血性脑卒中的疗效进行评估。对不同时间缺血组织超微结构进行观察。结果:HBO后神经功能预后明显好于对照组(P<0.01),5d时梗死容积比对照组显著降低(P<0.01),缺血组织毛细血管周围水肿和神经元损伤明显减轻。结论:超早期大剂量HBO治疗急性脑卒中疗效显著,过大剂量HBO可能加重过氧化损伤。
Aim：To evaluate the therapeutic effect of large dose hyperbaric oxygenation on super-early stage of acute cerebral artery occlusion in rats. Methods. The intraluminal middle cerebral artery permanent occlusion model （middle cerebral artery occlusion, MCAO） was used. The animals were randomly divided into two hyperbaric oxygenation（HBO） groups （9 h and 18 h） and a control group. Observation index： （1）Two neurological grading systems were used to assess the effects of HBO： the Garcia Neurological Score and the Bederson Neurological Score. （2）Twenty-four hours and 5 days after MCAO, the infarct volume was calculated with the use of TTC pathological staining and NIH Image J software. （3） Transmission electron microscope and mirror image method were used to observe the ultrastructural change of the cerebral infarct penumbra tissue of the rats at 3 h, 24 h and 5 d. Results： （1）Neurobehavioral outcome was distinctly improved in the rats of 9 h and 18 h groups. There was significant improvement in neurobehavioral outcome of the rats in 9 h and 18 h groups compared with control group（P 〈 0.01）. （2）There was no significant difference in neurobehavioral outcome between 9 h group and 18 h group. （3）Cerebral infarct volume decreased 63% and 64% at 24 h and 5 d in the 9 h group compared with control group, while cerebral infarct volume reduced 66% and 51% at 24 h and 5 d in the 18 h group compared with control group. （4） Astrocytes edema and neuron damage around capillary in the ischemia penumbra of infract cerebral tissue significantly relieved in the rats with HBO under transmission electron microscope. Conclusion ： （1） Large dose HBO is highly efficient in reducing infarct volume and improving neurobehavioral outcome in permanent middle cerebral artery occlusion within super-early stage. （2） Large dose HBO in super-early stage of permanent MCAO might have the important inhibiting or withdrawing effect on the pathologic progression of stroke. （3） The dosage of HBO is not the longer the better, it maybe aggravates the oxidative stress in ischemic tissue.
出处
《中国临床神经科学》
2007年第6期583-588,共6页
Chinese Journal of Clinical Neurosciences
基金
北京市优秀人才资助项目(2002)
关键词
高压氧治疗
大脑中动脉梗死
神经功能评分
梗死容积
超微结构
hyperbaric oxygenation
middle cerebral artery occlusion
neurobehavioral outcome
infarct volume
ultrastructure
