本文選題：重型顱腦損傷 + 去骨瓣減壓��； 參考：《川北醫(yī)學(xué)院》2017年碩士論文

【摘要】：目的:采用改良的Feeney's自由落體損傷裝置建立重型顱腦損傷動(dòng)物模型,運(yùn)用此模型進(jìn)行實(shí)驗(yàn)研究:1.亞低溫對(duì)重型顱腦損傷后大鼠TRPM2、caspase-9表達(dá)的影響;2.去骨瓣減壓術(shù)對(duì)重型顱腦損傷后大鼠TRPM2、caspase-9表達(dá)的影響;3.亞低溫治療聯(lián)合去骨瓣減壓術(shù)對(duì)重型顱腦損傷后大鼠TRPM2、caspase-9表達(dá)的影響;4.通過(guò)TRPM2、caspase-9的表達(dá)比較單純兩種治療及聯(lián)合治療方式對(duì)重型顱腦損傷療效的影響;5.為T(mén)RPM2通道靶點(diǎn)在STBI治療上的深入研究提供依據(jù)。方法:選取SPF(specific pathogen free)(清潔)級(jí)成年SD(Sprague-Dawley)雄性大鼠192只,體重280g~340g。隨機(jī)分為4組,顱腦損傷組(STBI組即僅鉆孔打擊)48只,顱腦損傷后亞低溫治療組(STBI+MHT組)48只,顱腦損傷后去骨瓣減壓治療組(STBI+DC組)48只,顱腦損傷后亞低溫聯(lián)合去骨瓣減壓組(STBI+MHT+DC組)48只,各組又根據(jù)打擊后不同時(shí)間點(diǎn)分為6個(gè)亞組,分別為打擊后6h、12h、24h、48h、72h和168h,每個(gè)時(shí)間點(diǎn)8只大鼠。損傷后不同時(shí)間點(diǎn)進(jìn)行斷頭,取腦損傷處腦組織來(lái)測(cè)定腦組織含水量(干濕稱(chēng)重法)、檢測(cè)TRPM2、casepase-9的表達(dá)(免疫組化法)。結(jié)果:1.干濕稱(chēng)重法結(jié)果:STBI組腦組織含水量:傷后6h開(kāi)始增加,12h進(jìn)一步增加,24h達(dá)高峰,48h開(kāi)始降低,72h明顯降低,168h降低更明顯。STBI+MHT組傷后6h、12 h遞增,24h達(dá)到高峰,48h、72h遞減,168h仍有水腫,與STBI組比較,各時(shí)間點(diǎn)腦組織含水量有顯著差異(p0.05);STBI+DC組傷后6h、12h遞增,24h達(dá)到高峰,48h、72h遞減,168h仍有水腫,與TBI組比較,各時(shí)間點(diǎn)腦組織含水量有顯著差異(p0.05);與STBI+MHT組比較,各時(shí)間點(diǎn)腦組織含水量有顯著差異(p0.05);STBI+MHT+DC組傷后6h、12h遞增,24h達(dá)到高峰,48h、72h遞減,168h趨于正常,與STBI組比較各時(shí)間點(diǎn)腦組織含水量有顯著差異(p0.05);與STBI+MHT組及TBI+DC組比較,傷后各時(shí)間點(diǎn)腦組織含水量有顯著差異(p0.05)。2.免疫組化法結(jié)果:TRPM2的陽(yáng)性細(xì)胞表達(dá)隨時(shí)間的變化而變化,在傷后6h、12h、24h、48h、72h、168h的各時(shí)間點(diǎn),TRPM2的表達(dá)呈現(xiàn)出先升高后降低的趨勢(shì),傷后6h即有升高,24h達(dá)到高峰,傷后168h降至最低。STBI+MHT組與STBI組比較各時(shí)間點(diǎn)TRPM2表達(dá)有顯著差異(p0.05);STBI+DC組與STBI組比較各時(shí)間點(diǎn)TRPM2表達(dá)有顯著差異(p0.05);STBI+DC組與STBI+MHT組比較各時(shí)間點(diǎn)TRPM2表達(dá)有顯著差異(p0.05);STBI+MHT+DC組與STBI組比較各時(shí)間點(diǎn)TRPM2表達(dá)有顯著差異(p0.05);STBI+MHT+DC組與STBI+DC組各時(shí)間點(diǎn)TRPM2表達(dá)有顯著差異(p0.05);STBI+MHT+DC組與STBI+MHT組各時(shí)間點(diǎn)TRPM2表達(dá)有顯著差異(p0.05)。Casepase-9的陽(yáng)性細(xì)胞表達(dá)隨時(shí)間的變化而變化,在傷后6h、12 h、24h、48h、72h、168h的各時(shí)間點(diǎn),casepase-9的表達(dá)呈現(xiàn)出先升高后降低的趨勢(shì),傷后6h即有升高,24h達(dá)到高峰,傷后168h降至最低。STBI+MHT組與STBI組比較各時(shí)間點(diǎn)casepase-9表達(dá)有顯著差異(p0.05);STBI+DC組與STBI組比較各時(shí)間點(diǎn)casepase-9表達(dá)有顯著差異(p0.05);STBI+DC組與STBI+MHT組比較各時(shí)間點(diǎn)有顯著差異(p0.05);STBI+MHT+DC組與STBI組比較各時(shí)間點(diǎn)casepase-9表達(dá)有顯著差異(p0.05);STBI+MHT+DC組與STBI+DC組各時(shí)間點(diǎn)casepase-9表達(dá)有顯著差異(p0.05);STBI+MHT+DC組與STBI+MHT組各時(shí)間點(diǎn)casepase-9表達(dá)有顯著差異(p0.05)。結(jié)論:1.本實(shí)驗(yàn)方法采用改良Feeney's法自由落體制作顱腦損傷模型,成功建立大鼠重型顱腦損傷模型,其制作方法具有簡(jiǎn)單、可控性好、可重復(fù)性好的特點(diǎn);2.顱腦損傷后氧化應(yīng)激可使過(guò)度的TRPM2表達(dá),Caspase-9表達(dá)水平相應(yīng)增加,促使細(xì)胞凋亡,加重繼發(fā)性腦損傷;3.去大骨瓣減壓、亞低溫治療均對(duì)重型顱腦損傷具有治療作用,且兩種治療方法具有協(xié)同作用,聯(lián)合治療優(yōu)于單一治療。
[Abstract]:Objective: to establish an animal model of severe craniocerebral injury with a modified Feeney's free falling body damage device and use this model to study the effect of 1. mild hypothermia on the expression of TRPM2 and caspase-9 in rats after severe craniocerebral injury; (2.) the effect of bone flap decompression on the expression of TRPM2 and caspase-9 in rats after severe craniocerebral injury; 3. hypothermia therapy The effect of combined bone flap decompression on the expression of TRPM2 and caspase-9 in rats after severe craniocerebral injury; 4. through the expression of TRPM2 and caspase-9, the effect of pure two treatment and combined therapy on severe craniocerebral injury was compared; 5. the TRPM2 channel targets were provided for in-depth study on STBI treatment. Methods: SPF (specific pathogen FR) was selected. EE) (EE) (clean) grade adult SD (Sprague-Dawley) male rats, body weight 280g~340g. randomly divided into 4 groups, craniocerebral injury group (group STBI or only drilling) 48, 48 after craniocerebral injury, mild hypothermia treatment group (group STBI+MHT), 48 after craniocerebral trauma decompression treatment group (group STBI+DC), mild hypothermia combined with bone flap decompression group after craniocerebral injury (STB) Group I+MHT+DC) 48, each group was divided into 6 subgroups according to the different time points after the attack, which were after the attack of 6h, 12h, 24h, 48h, 72h and 168h, and 8 rats at each time point. After the injury, the brain tissue was taken to determine the water content of the brain tissue (dry wet weighing method), and the expression of TRPM2 and casepase-9 (immunohistochemistry) was detected. Results: 1. the results of dry and wet weighing method: the water content of brain tissue in group STBI: after injury, 6h began to increase, 12h increased further, 24h reached its peak, 48h began to decrease, 72h decreased obviously, 168h decreased more obviously after.STBI+MHT group, and the 24h reached the peak, 48H, decreased, and still had edema. Compared with the group, the water content of brain tissue at each time point was significantly worse. In group STBI+DC, 6h, 12h increased, 24h reached the peak, 48h, 72h decreased, 168h still had edema. Compared with the TBI group, the water content of the brain tissue was significantly different at each time point (P0.05). Compared with the STBI+MHT group, the water content of the brain tissue was significantly different (P0.05) at each time point (P0.05). Compared with group STBI and group TBI+DC, the water content of brain tissue was significantly different from that of group STBI+MHT and TBI+DC (P0.05).2. immunohistochemical method: the expression of positive cells in TRPM2 changes with time, and 6h, 12h, 24h, 48h, 72h, and all time points after injury. The expression of TRPM2 showed a tendency to increase first and then decrease, and the 6h increased after injury, and the 24h reached the peak. The 168h decreased to the lowest.STBI+MHT group after the injury and the TRPM2 expression at each time point in the.STBI+MHT group was significantly different (P0.05). The STBI+DC group compared with the STBI group, there was a significant difference (P0.05) in each time point (P0.05). The expression of TRPM2 was significantly different (P0.05), and there was significant difference in TRPM2 expression between group STBI+MHT+DC and STBI group at each time point (P0.05); the expression of TRPM2 in STBI+MHT+DC group and STBI+DC group at each time point was significantly different (P0.05), and the expression of positive cells in STBI+MHT+DC group and STBI+MHT group The changes in the time points of 6h, 12 h, 24h, 48h, 72h, 168h after injury, the expression of casepase-9 showed a tendency to increase first and then decrease, and 6h increased after injury, 24h reached its peak, and 168h decreased to the lowest level in.STBI+MHT group after injury. There was significant difference in point casepase-9 expression (P0.05), and there was significant difference in time points between group STBI+DC and STBI+MHT group (P0.05), and there was significant difference in casepase-9 expression between STBI+MHT+DC and STBI groups at each time point (P0.05), and there was a significant difference between STBI+MHT+DC and STBI+DC groups at each time point. The expression of time point casepase-9 was significantly different (P0.05). Conclusion: 1. the experimental method used the modified Feeney's free falling body to make the brain injury model, and successfully established the model of severe brain injury in rats. The production method was simple, good controllability and reproducible characteristics. 2. the oxidative stress after craniocerebral injury can make the excessive expression of TRPM2, Ca The expression level of spase-9 increases correspondingly, promotes cell apoptosis and aggravates secondary brain injury; 3. decompression of large bone flap and mild hypothermia therapy have therapeutic effect on severe craniocerebral injury, and two kinds of treatment methods have synergistic effect, combined therapy is superior to single treatment.
【學(xué)位授予單位】：川北醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R651.15

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