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高压氧治疗急性胸段脊髓损伤:改善大鼠运动功能恢复。

Hyperbaric Oxygen Therapy After Acute Thoracic Spinal Cord Injury: Improvement of Locomotor Recovery in Rats.

机构信息

Laboratory of Basic Studies on Spinal Cord Pathologies, Department of Neurosurgery, Post-Graduation Program in Health Science, University of Caxias do Sul, Caxias do Sul, Rio Grande do Sul, Brazil.

出版信息

Spine (Phila Pa 1976). 2018 Apr 15;43(8):E442-E447. doi: 10.1097/BRS.0000000000002387.

Abstract

STUDY DESIGN

A controlled laboratory study.

OBJECTIVE

The aim of this study was to analyze the effectiveness of hyperbaric therapy (HT) using mild and moderate models of spinal cord injury (SCI).

SUMMARY OF BACKGROUND DATA

SCI can cause permanent impairment with socioeconomic consequences. The motor deficit occurs by two mechanisms: destruction of neuronal cells and local inflammatory response, resulting in hypoxia. HT acts by increasing oxygen in the injured area.

METHODS

Thoracic laminectomy was performed in 72 female Wistar rats. The MASCIS impactor was used at 12.5 mm (n = 35) and 25 mm (n = 35) of height to perform, respectively, mild and moderate SCI. Muscle strength was assessed through the Basso, Beattie, and Bresnahan scale (BBB) on days 1, 7, 14, 21, and 28 after SCI. The animals were randomized into five subgroups with seven animals each: (1) control group had SCI without HT; (2) HT 30 minutes after SCI; (3) HT 30 minutes after SCI and daily for 7 days; (4) HT 12 hours after SCI; and (5) HT 12 hours after SCI and daily for 7 days. HT was performed at 2.5 atm for 1 hour.

RESULTS

There was a linear relationship between injury severity and motor deficit until day 21, with similar BBB scores on day 28. A pattern of uniform lesions was observed in the mild SCI, with lower variation of BBB when compared with moderate SCI. All animals that underwent HT had significant improvement in motor function and histology when compared with control group. Regardless of the injury model, animals submitted to 7-day protocols had an early improvement in motor function and a smaller area of histological injury.

CONCLUSION

The present study reported that the sooner HT is begun after mild and moderate SCI and the larger the number of sessions, the greater and earlier is the motor recovery and smaller is the tissue injury.

LEVEL OF EVIDENCE

N/A.

摘要

研究设计

对照实验室研究。

目的

本研究旨在分析高压氧疗法(HT)对轻度和中度脊髓损伤(SCI)的疗效。

背景资料概要

SCI 可导致永久性损伤,造成社会经济后果。运动功能障碍通过两种机制发生:神经元细胞破坏和局部炎症反应导致缺氧。HT 通过增加损伤区域的氧气起作用。

方法

72 只雌性 Wistar 大鼠行胸段椎板切除术。使用 MASCIS 撞击器分别以 12.5mm(n=35)和 25mm(n=35)的高度进行轻度和中度 SCI。在 SCI 后第 1、7、14、21 和 28 天通过 Basso、Beattie 和 Bresnahan 量表(BBB)评估肌肉力量。动物随机分为 5 组,每组 7 只:(1)对照组 SCI 后不进行 HT;(2)SCI 后 30 分钟进行 HT;(3)SCI 后 30 分钟进行 HT,每日 1 次,持续 7 天;(4)SCI 后 12 小时进行 HT;(5)SCI 后 12 小时进行 HT,每日 1 次,持续 7 天。HT 在 2.5 大气压下进行 1 小时。

结果

损伤严重程度与运动缺陷之间存在线性关系,直至第 21 天,第 28 天 BBB 评分相似。轻度 SCI 中观察到均匀的病变模式,与中度 SCI 相比,BBB 评分变化较小。与对照组相比,所有接受 HT 的动物运动功能和组织学均有显著改善。无论损伤模型如何,接受 7 天方案的动物运动功能均较早改善,组织损伤面积较小。

结论

本研究报告称,轻度和中度 SCI 后越早开始 HT,治疗次数越多,运动恢复越大,组织损伤越小。

证据水平

N/A。

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