大鼠重型颅脑创伤后急性期下丘脑—垂体—肾上腺轴损害及功能改变意义.docVIP

大鼠重型颅脑创伤后急性期下丘脑—垂体—肾上腺轴损害及功能改变意义 【摘要】目的 探讨大鼠重型颅脑创伤（traumatic brain injury，TBI）后急性期下丘脑-垂体-肾上腺（hypothalamic-pituitary-adrenal，HPA）轴损害和功能改变的意义。方法 成年健康封闭群雄性SD大鼠60只，随机（随机数字法）分为假手术组、模型组和治疗组，每组20只。采用Feeney法建立大鼠重型TBI模型。治疗组于伤后10 min、24 h和48 h腹腔注射地塞米松0.6 mg/kg，假手术组和模型组给予等容量生理盐水替代。各组大鼠腹腔注射1 μg促肾上腺皮质激素（adrenocorticotropic hormone，ACTH）作刺激试验，分别于伤后第3、12、24、72小时4个时间点进行观察。应用化学发光法测定血清皮质酮（corticosterone，CORT）和ACTH含量。第72小时取大鼠下丘脑、垂体和肾上腺，采用免疫组织化学方法观察白细胞介素6（ interleukin-6，IL-6）和肿瘤坏死因子α（tumor necrosis factor-alpha，TNF-α）表达情况。所得数据采用SPSS 17.0统计软件包进行单因素方差分析和SNK-q检验。结果 ①模型组大鼠伤后第3小时外周血CORT和ACTH达高峰，明显高于假手术组，随后逐渐降低；各时间点ACTH刺激试验后CORT上升的幅度（Δmax）均低于假手术组（P【关键词】颅脑创伤；下丘脑-垂体-肾上腺轴；促肾上腺皮质激素；皮质酮；白细胞介素6；肿瘤坏死因子α；大鼠 The clinical significance of the injury and functional change of hypothalamic-pituitary-adrenal axis after acute severely traumatic brain injury in the rats CHEN Zhong-zhen， WU Si-rong， LING Wei-hua， LI Xiang-dong， SHAN Li-dong， WANG Jun， XU Feng， HUI Guo-zhen. Department of Emergency， The First Affiliated Hospital of Soochow University， Suzhou 215006， China Corresponding author： WU Si-rong， Email： wusirongmd@ 【Abstract】Objective To study the clinical significance of the injury and functional change of hypothalamic-pituitary-adrenal （HPA） axis after acute severe traumatic brain injury （TBI） in the rats. MethodsA total of 60 adult healthy male Spraque-Dawley rats were randomly （random number） divided into 3 groups （n=20 in each group ）： sham operation group， model group and treatment group. The TBI models of rats were established by Feeney’s method. A low dose of dexamethasone （0.6 mg/kg） was injected into the abdominal cavity 20 minutes， 24 hours and 48 hours after injury in treatment group， while rats of sham operation group and model group received equal volume of normal saline instead. All the rats were injected 1 μg adrenocorticotropic hormone （ACTH） into the abdominal cavity. The related parameters were detected at four time points， 3 hours， 12 hours， 24 hours and 72 hours after cerebral c