右美托咪定对重度颅脑创伤大鼠脑水肿程度的影响

李正超; 钱传云; 吴海鹰; 张玮; 夏婧

右美托咪定对重度颅脑创伤大鼠脑水肿程度的影响

昆明医科大学第一附属医院急诊医学科EICU

基金项目:

基金：云南省教育厅科学研究基金资助项目 (2014J043);

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出版历程
- 收稿日期: 2017-03-01

Effect of Dexmedetomidine on Brain Edema in Rats with Severe Traumatic Brain Injury

Funds:

基金：云南省教育厅科学研究基金资助项目 (2014J043);

摘要

摘要: 目的研究右美托咪定对重度颅脑创伤 (TBI) 后大鼠大脑水肿程度的影响.方法制作SD大鼠颅脑创伤模型, 并使用右美托咪定进行治疗干预, 观察72 h内大鼠神经功能损害程度、脑组织含水量和BBB通透性的变化.结果不同组TBI大鼠各时间点NSS评分:主体内效应差异有统计学意义 (P=0.041) , 主体间效应差异有统计学意义 (P<0.001) ;不同组TBI大鼠各时间点脑组织含水量:主体内效应差异有统计学意义 (P=0.032) , 主体间效应差异有统计学意义 (P<0.001) ;神经功能评分和脑水肿程度具有相关性 (r=0.61, P<0.001) 结论 TBI大鼠脑水肿高峰为TBI后24 h;TBI大鼠在损伤早期使用右美托咪定镇静治可降低BBB通透性及减轻大鼠脑组织水肿, 从而促进神经功能恢复.
- 颅脑创伤脑水肿 /
- 右美托咪定 /
- AQP4
Abstract: Objective To study the effect of dexmedetomidine on brain edema in rats with severe traumatic brain injury (TBI) .Methods SD rat traumatic brain injury model was established and was treated with dexmedetomidine.The changes of neurological impairment, brain water content and BBB permeability were observed within 72 hours after injury.Results The NSS score of different TBI rats in different groups:the difference of internal effect was statistically significant (P=0.041) , and the difference between subjects was statistically significant (P<0.001) .The water content of the brain tissue in different groups of TBI rats was statistically significant (P=0.032) , and the difference between subjects was statistically significant (P<0.001) .The correlation was found between neurological score and cerebral edema degree (r=0.61, P<0.001) .Conclusions TBI rat cerebral edema peaks at 24 h after TBI.Dexmedetomidine can reduce BBB permeability and reduce the edema of TBI rats in the early stage of injury, thereby promoting the recovery of nerve function.
- Traumatic brain injury /
- Brain edema /
- Dexmedetomidine

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参考文献(20)

[1]	[1]BADAUTJ, ASHWALS, ADAMIA, et al.Brain water mobility decreases after astrocytic aquaporin-4 inhibition using RNA interference[J].Journal of Cerebral Blood Flow&Metabolism, 2010, 31 (3) :819-831.
[2]	[2]ISOARDO G AND I MORRA.Different aquaporin-4 expression in glioblastoma multiforme patients with and without seizures[J].Molecular Medicine, 2012, 18 (7) :1-4.
[3]	[3]SONG Y, GUNNARSON E.Potassium dependent regulation of astrocyte water permeability is mediated by c AMPSignaling[J].PLo S ONE, 2012, 7 (4) :349-356.
[4]高峰, 闫玉仙, 毕海涛等.脑外伤后继发性损伤研究现状[J].武警后勤学院学报 (医学版) , 2013, 22 (12) :1120-1122.
[5]刘永亮, 王鹏与李建民.颅脑损伤后脑水肿的发病机制研究进展[J].中国医药指南, 2013, (8) :76-78.
[6]	[6]BADAUT J, FUKUDA A M, JULLIENNE A, et al.Aquaporin and brain diseases[J].Biochim Biophys Acta, 2014, 1840 (5) :1554-1556.
[7]沈礼芹, 蒋金泉与郭建杰, 脑挫裂伤后脑组织中AQP4的表达变化及意义[J].山东医药, 2011, 51 (26) :6-8.
[8]	[8]MCCOY E, SONTHEIMER H.MAPK induces AQP1 expression in astrocytes following injury[J].Glia, 2010, 8 (2) :209-217.
[9]	[9]HEMPHILL M A, DABIRI B E, GABRIELE S, et al.A Possible Role for Integrin Signaling in Diffuse Axonal Injury[J].PLo SONE, 2011, 6 (7) :228-231.
[10]	[10]SELLMANN T, MIERSCH D, KIENBAUM P, et al.The impact of arterial hypertension on polytrauma and traumatic brain injury[J].Dtsch Arztebl Int, 2012, 109 (49) :849-855.
[11]	[11]TERPOLILLINA, KIMS, THAL S C, et al.Inhaled nitric oxide reduces secondary brain damage after traumatic brain injury in mice[J].Journal of Cerebral Blood Flow&Metabolism, 2012, 33 (2) :311-318.
[12]	[12]HARRIS J L, YEHH, CHOII, et al.Altered neurochemical profile after traumatic brain injury:1H-MRS biomarkers of pathological mechanisms[J].Journal of Cerebral Blood Flow&Metabolism, 2012, 32 (12) :2122-2124.
[13]	[13]DEVABHAKTHUNIS, PAJOUMANDM, WILLIAMS C, et al.Evaluation of dexmedetomidine:Safety and clinical outcomes in critically Ill Trauma patients[J].The Journal of Trauma:Injury, Infection, and Critical Care, 2011, 71 (5) :1164-1171.
[14]	[14]HOYLE J J, CALLAHANJM, BADAWYM, et al.Pharmacologicalsedation for cranialcomputedtomography in childrenafterminorbluntheadtrauma[J].Pediatr Emerg Care, 2014, 30 (1) :1-7.
[15]	[15]LOPIZZO, SCHIERAG, DILIEGRO, et al.Aquaporin-4distribution in control and stressed astrocytes in culture and in the cerebrospinal fluid of patients with traumatic brain injuries[J].Neurological Sciences, 2015, 34 (8) :1309-1314.
[16]	[16]FUKUDA A M, BADAUT J.Aquaporin 4:a player in cerebral edema and neuroinflammation[J].Journal of Neuroinflammation, 2016, 9 (1) :279.
[17]	[17]BOUTST, TAYLORP, BERRYK, et al.Evaluation of medetomidine-ketamine and dexmedetomidine-ketamine in Chinese water deer (Hydropotesinermis) [J].Veterinary Anaesthesia and Analgesia, 2014, 38 (2) :106-112.
[18]	[18]KONG L, LIAN G, ZHENG W, et al.Effect of alcohol on diffuse axonal injury in rat brainstem:Diffusion tensor imaging and aquaporin-4 expression study[J].Bio Med Research International, 2013, 20 (13) :1-9.
[19]	[19]SHENAQM, HERRYJ, TAYLORH, et al.Neuronal damage and functional deficits are ameliorated by inhibition of aquaporin and HIF1αafter traumatic brain injury (TBI) [J].Journal of the Neurological Sciences, 2016, 323 (2) :134-140.
[20]	[20]BENGGONM, CHENH, APPLEGATE R, et al.Effect of dexmedetomidine on brain edema and neurological outcomes in surgical brain injury in rats[J].Anesthesia&Analgesia, 2015, 115 (1) :154-159.

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