低温治疗影响脊髓损伤内部环境的机制

发布时间：2018-10-31 21:19

【摘要】：背景:脊髓损伤是一种具有高致残率的中枢神经系统损伤疾病。脊髓损伤包括原发性损伤和继发性损伤,继发性损伤所带来的机体损伤程度明显高于原发性损伤,继发性损伤具有可调控性,人为干预可以改善继发性损伤所造成的机体不利微环境。目前,除了手术减压和药物等传统方式治疗外,低温治疗是一种重要的物理干预手段。低温治疗,已经被证实在脊髓损伤后具有调节继发性损伤,保护神经功能。目的:介绍低温治疗脊髓损伤的不同低温方式的特点以及低温治疗在改善脊髓损伤后机体不利微环境的作用,总结近些年来低温治疗脊髓损伤的相关研究进展。方法:在CNKI和PubMed等数据库中检索2001年1月至2016年6月的关于低温治疗在脊髓损伤中应用的文章,中文以"低温治疗,脊髓损伤"为检索词检索;英文以"therapeutic hypothermia or low temperature;spinal cord injury"为检索词进行检索。结果与结论:低温治疗分为系统低温和局部低温,系统低温操作简单、方便,但其可能会引起其他系统并发症。局部低温能够快速达到目标体温,其使受伤部位深低温并且系统核心温度趋于稳定体温,但需要有创手术,存在定位和维持有效温度必要时间的问题。总的来说,低温可以调节脊髓损伤后的不利微环境,减少炎症、影响相关基因蛋白的表达等益处,在一定程度上能够促进内源性神经细胞增殖分化。目前,国内外对低温治疗脊髓损伤已经具有一定的理论研究与实践基础,从不同方面论证低温治疗对中枢神经系统损伤具有神经保护作用,因此低温治疗有望成为未来脊髓损伤的重要策略之一。
[Abstract]:Background: spinal cord injury (sci) is a kind of central nervous system injury with high disability rate. Spinal cord injury includes primary injury and secondary injury. The degree of body injury caused by secondary injury is obviously higher than that of primary injury. Secondary injury is controllable. Human intervention can improve the adverse microenvironment caused by secondary injury. At present, hypothermia therapy is an important physical intervention in addition to surgical decompression and drug therapy. Hypothermia therapy has been proved to regulate secondary injury and protect nerve function after spinal cord injury. Objective: to introduce the characteristics of hypothermia in treating spinal cord injury (sci) and the role of hypothermia in improving the unfavorable microenvironment after spinal cord injury (sci), and to summarize the research progress of hypothermia in spinal cord injury (sci) in recent years. Methods: from January 2001 to June 2016, articles on the application of hypothermia therapy in spinal cord injury were searched in CNKI and PubMed databases. The key words were "hypothermia therapy, spinal cord injury" in Chinese and "therapeutic hypothermia or low temperature;" in English. Spinal cord injury "is searched for the key word." Results & conclusion: hypothermia therapy can be divided into systemic hypothermia and local hypothermia. Local hypothermia can quickly reach the target temperature, which makes the injured part deep hypothermia and the core temperature of the system tends to stabilize body temperature, but it needs invasive operation, and there is the problem of locating and maintaining the effective temperature necessary time. In general, hypothermia can regulate the adverse microenvironment after spinal cord injury, reduce inflammation, affect the expression of related gene proteins, and promote the proliferation and differentiation of endogenous nerve cells to some extent. At present, there is a theoretical and practical basis for hypothermia treatment of spinal cord injury at home and abroad. It is demonstrated from different aspects that hypothermia therapy has neuroprotective effect on central nervous system injury. Therefore hypothermia therapy is expected to be one of the important strategies for spinal cord injury in the future.
【作者单位】：天津医科大学;天津医科大学总医院;武警后勤学院附属医院脑科中心;
【基金】：国家自然科学基金青年项目(81101362,11102235) 天津市自然科学基金重点项目(12JCZDJC24100)~~
【分类号】：R651.2

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