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脊髓火器伤和打击伤早期病理生理变化的对照研究

Pathophysiology at Early Stage of Spinal Cord Injury from Gunshot: A Control Study

【作者】 陈长春

【导师】 李家顺; 贾连顺; 袁文; 叶晓健; 田纪伟;

【作者基本信息】 第二军医大学 , 外科学, 2005, 博士

【摘要】 建立猪胸腰段脊髓火器伤模型和改良Allen’s打击后全瘫模型,观察早期全身及局部病理改变。结果发现:胸腰段脊髓火器伤早期死亡原因可能是多发伤引起的低血容量性休克,而心脏损伤和肾脏损伤加速了早期死亡。两组伤后1h即可发现神经元破坏、崩解,6h发现神经胶质细胞表达增加。细胞凋亡基因P-53和Bax基因在脊髓损伤后3h出现转录水平(mRNA)和蛋白水平的表达量增加,6h内随着时间延长而表达上调。而Bcl-2基因在脊髓损伤后6h出现转录水平(mRNA)和蛋白水平的表达量增加。脊髓火器伤的波及范围较打击伤更为广泛。

【Abstract】 The porcine models of gunshot injury to thoraciclumbar spinal cord andcomplete paraplegia of contusion model of SCI using the modified Allen’s method were established in this study, which we analyze the early systemic and local pathophysical changes. It is concluded that hypovolumic shock from multiple organ injury cause death, meanwhile, one of the most important role in the high mortality at early stage is heart and kidney injury. Just lh after the injury the destruction and lysis of neuron could be observed, 6h after injury the number of glial cells increased in both models. Levels of transcription and protein expression of P-53 and bax gene began to increase since 3h after injury and up-regulated during the following 6h after injury, which bcl-2 gene began to rise since 6h. However, the injury area of gunshot SCI would be more extensive than that of the Allen’s method induced injury.

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