合并低氧血症大鼠创伤性轴索损伤通气复苏策略的研究

发布时间：2018-03-18 23:40

本文选题：低氧血症　切入点：创伤性轴索损伤　出处：《上海交通大学》2014年硕士论文　论文类型：学位论文

【摘要】：研究目的 1.在创伤性轴索损伤(TAI)合并低氧血症性二次脑损伤（SBI）大鼠模型基础上进行不同氧浓度复苏，分析比较不同氧浓度复苏之间大鼠动脉血气指标的变化规律，探讨不同氧浓度对动脉血气的影响。 2.在创伤性轴索损伤(TAI)合并低氧血症性二次脑损伤（SBI）大鼠模型基础上进行不同氧浓度复苏，分析比较不同氧浓度复苏之间对大鼠组织病理学的变化规律，探讨不同氧浓度对损伤轴索的影响研究方法 1.采用自制联合损伤装置制作TAI模型，经小动物呼吸机吸入低浓度氧构建低氧血症，从而形成TAI合并低氧血症的大鼠模型。 2.在此模型基础上，对氧复苏后大鼠动脉血行血气分析，研究不同氧浓度复苏对大鼠动脉血气变化的影响。 3.在此模型基础上，对氧复苏后大鼠脑组织行β-APP免疫组化染色,研究不同氧浓度复苏对大鼠脑组织病理变化的影响。研究结果 1.给予21%氧浓度混合气体时，PaO2迅速上升，接近正常水平；50%氧浓度时，PaO2上升至正常时的1.8倍；75%氧浓度时，，是正常时的2.0倍；100%氧浓度时是正常时的2.9倍。给予21%氧浓度混合气体时，SaO2迅速升高，接近正常水平；50%氧浓度时，SaO2接近100%；75%、100%氧浓度时，SaO2为100%。不同氧浓度通气复苏后，即各组内致伤后60min、90min（即通气复苏30min、60min）时两者之间PaO2和SaO2基本一致。 2.延髓部位ROI的β-APP免疫组化染色显示，24h时TAI合并缺氧组的阳性染色明显强于各复苏组，50%氧浓度时的阳性染色最弱；各组阳性染色随时间而减弱，1w时各组阳性染色明显弱于24h，此时TAI合并缺氧组的阳性染色仍明显强于各复苏组，50%氧浓度时的阳性染色最弱。染色阳性的神经轴索半定量分析显示，24h时TAI合并缺氧组明显高于各复苏组，50%氧浓度时的值最低；各组数值随时间而降低，1w时各组值明显低于24h，此时TAI合并缺氧组的值仍高于各复苏组，50%氧浓度的值仍为最低。研究结论 1、给氧治疗可以明显改善创伤后缺氧大鼠的动脉氧分压和氧饱和度，而且随着氧浓度的升高其动脉氧分压逐渐升高。 2、给氧治疗可以显著减低轴索损伤的程度，起到神经保护作用。 3、对于此TAI合并缺氧动物模型的最佳复苏氧浓度为50%。
[Abstract]:Research purpose. 1. On the basis of the model of traumatic axonal injury (TAI) combined with hypoxemia secondary brain injury (SBI), resuscitation with different oxygen concentrations was carried out, and the changes of arterial blood gas indexes in rats with different oxygen concentration resuscitation were analyzed and compared. To study the effect of different oxygen concentration on arterial blood gas. 2. Different oxygen concentration resuscitation was carried out on the basis of traumatic axonal injury (TAI) combined with hypoxemia secondary brain injury (SBI) rat model, and the changes of histopathology between different oxygen concentration resuscitation were analyzed and compared. Study on the effect of different oxygen concentration on damaged axons. Research method. 1. TAI model was made by using self-made combined injury device. Hypoxemia was established by inhaling low concentration oxygen through small animal ventilator, and then the rat model of TAI combined with hypoxemia was established. 2. On the basis of this model, the arterial blood gas of rats after oxygen resuscitation was analyzed to study the effect of different oxygen concentration resuscitation on the changes of arterial blood gas in rats. 3. On the basis of this model, 尾 -APP immunohistochemical staining was used to study the effect of different oxygen concentration resuscitation on the pathological changes of rat brain tissue after oxygen resuscitation. Research results. 1. PaO2 increased rapidly when 21% oxygen concentration was given to mixed gas, and Pao _ 2 increased to 1.8-fold 75% oxygen concentration when it was close to the normal level of 50% oxygen concentration. It is 2. 0 times 100% oxygen concentration at normal level and 2. 9 times as high as 2. 9 times at normal oxygen concentration. When 21% oxygen concentration mixture gas is given, SaO2 increases rapidly, and at 50% oxygen concentration near normal level, SaO2 is close to 100. When oxygen concentration is close to 100%, SaO2 is 100. After different oxygen concentration is resuscitated, In other words, PaO2 and SaO2 were basically the same between the two groups at 60 minutes after injury (30 minutes after resuscitation and 60 minutes after ventilation resuscitation). 2. 尾 -APP immunohistochemical staining of ROI in medulla oblongata showed that the positive staining of TAI combined with hypoxia at 24 h was significantly stronger than that of 50% oxygen concentration in resuscitation group. The positive staining of each group was significantly weaker than that of 24 hours after weakening with time. At this time, the positive staining of TAI combined with hypoxia was still significantly stronger than that of the resuscitation group with 50% oxygen concentration. The neuronal axonal semilayer with positive staining was still stronger than that of the resuscitation group with 50% oxygen concentration. Quantitative analysis showed that TAI combined with hypoxia at 24 h was significantly higher than the lowest at 50% oxygen concentration in each resuscitation group. The values of each group were significantly lower than that of the control group for 24 hours, and the value of TAI combined with hypoxia was still higher than that of the resuscitation group (50% oxygen concentration). Research conclusion. 1. Oxygen administration could significantly improve the arterial oxygen partial pressure and oxygen saturation in rats with post-traumatic hypoxia, and the arterial oxygen partial pressure increased gradually with the increase of oxygen concentration. 2. Oxygen therapy can significantly reduce the degree of axonal injury and play a neuroprotective role. 3. The optimal resuscitation oxygen concentration for this TAI combined with hypoxia animal model is 50.
【学位授予单位】：上海交通大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R651.15

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