中国组织工程研究

中国组织工程研究 ›› 2017, Vol. 21 ›› Issue (20): 3263-3268.doi: 10.3969/j.issn.2095-4344.2017.20.023

• 组织构建综述 tissue construction review • 上一篇    下一篇

低温治疗影响脊髓损伤内部环境的机制

朱双龙1，2，3，陈旭义3，徐云强1，2，张  赛3   

  1. 1天津医科大学，天津市  300052；2天津医科大学总医院，天津市  300052；3武警后勤学院附属医院脑科中心，天津市  300162
  • 修回日期:2017-02-10 出版日期:2017-07-18 发布日期:2017-07-28
  • 通讯作者: 徐云强，博士，副主任医师，硕士生导师，天津医科大学，天津市300052；天津医科大学总医院，天津市 300052
  • 作者简介:朱双龙，男，1989年生，安徽省合肥市人，汉族，天津医科大学在读硕士，主要从事脊柱外科神经损伤修复研究。 并列第一作者：陈旭义，男，浙江省温州市人，博士，硕士生导师，副主任医师，主要从事神经创伤与再生、组织工程、三维打印、生物力学研究及神经外科专业方面的研究。
  • 基金资助:

    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)

Hypothermia regulates the internal environment following spinal cord injury: the underlying mechanisms

Zhu Shuang-long1, 2, 3, Chen Xu-yi3, Xu Yun-qiang1, 2, Zhang Sai3   

  1. 1Tianjin Medical University, Tianjin 300052, China; 2General Hospital of Tianjin Medical University, Tianjin 300052, China; 3Brain Center, Affiliated Hospital of Logistics College of CAPF, Tianjin 300162, China
  • Revised:2017-02-10 Online:2017-07-18 Published:2017-07-28
  • Contact: Xu Yun-qiang, M.D., Associate chief physician, Master’s supervisor, Tianjin Medical University, Tianjin 300052, China; General Hospital of Tianjin Medical University, Tianjin 300052, China
  • About author:Zhu Shuang-long, Studying for master’s degree, Tianjin Medical University, Tianjin 300052, China; General Hospital of Tianjin Medical University, Tianjin 300052, China; Brain Center, Affiliated Hospital of Logistics College of CAPF, Tianjin 300162, China. Chen Xu-yi, M.D., Master’s supervisor, Associate chief physician, Brain Center, Affiliated Hospital of Logistics College of CAPF, Tianjin 300162, China. Zhu Shuang-long and Chen Xu-yi contributed equally to this work.
  • Supported by:

    the Youth Project of the National Natural Science Foundation of China, No. 81101362, 11102235; the Key Project of the Natural Science Foundation of Tianjin, No. 12JCZDJC24100

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被引次数

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摘要：

文章快速阅读：

文题释义：
低温治疗：目前脊髓损伤的治疗方法很多，效果各异。低温治疗能够有效地减少继发性脑和脊髓损伤，从而保护神经系统。目前低温可分为轻度低温、中度低温、深低温和极深低温，范围分别为32-35 ℃/28-32 ℃、17-28 ℃和2-16 ℃，前二者合称为亚低温。
脊髓损伤：属于中枢神经系统损伤疾病，其包括原发性损伤和继发性损伤。继发性损伤目前是脊髓损伤的治疗关键点，延缓或减轻脊髓继发性损伤有利于神经系统损伤后的神经保护，促进脊髓损伤的恢复。脊髓损伤具有高发病率和致残率，在美国脊髓损伤影响240 000-340 000人，每年约有12 500例新增患者。中国脊柱损伤发病率为25-35/10万人，男性发病率高于女性。

 

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。

 

ORCID:0000-0002-5339-7676(朱双龙)

关键词: 组织构建, 组织工程, 脊髓损伤, 中枢神经系统, 系统低温, 局部低温, 微环境, 炎症, 神经保护, 国家自然科学基金

Abstract:

BACKGROUND: Spinal cord injury is a damage to the spinal cord with a high morbidity that can be divided into primary and secondary injury. Secondary injury does more harm to the body than primary injury, which can be regulated and improved through proper interventions. In addition to the drugs, surgical decompression and other traditional treatments, hypothermia is an important physical intervention that has been shown to regulate secondary injury following spinal cord injury, and hold neuroprotective effect.
OBJECTIVE: To introduce different hypothermia treatments for spinal cord injury and the effect on the disordered environment after spinal cord injury, as well as summarize the latest progression.
METHODS: A computer-based search of CNKI and PubMed databases was conducted for the articles addressing the application of hypothermia in spinal cord injury published from January 2001 to June 2016, using the keywords of “therapeutic hypothermia or low temperature, spinal cord injury” in Chinese and English, respectively.
RESULTS AND CONCLUSION: Hypothermia is divided into systematic and local hypothermia, and the former is simple and convenient, but it may lead to complications. Local hypothermia can quickly reach the target temperature, to make deep hypothermia at injury site and stablize the core temperature in the body, but it is invasive, and the necessary time of locating and maintaining effective temperature is a challenge. In general, hypothermia can improve the disordered microenvironment after spinal cord injury, reduce inflammatory infiltration, regulate the expression of relative genes and proteins, and promote the proliferation and differentiation of endogenous nerve cells. There are basic and clinical studies on hypothermia neuroprotection against spinal cord injury from various aspects; thereafter, hypothermia is a promising treatment strategy for spinal cord injury.

 

Key words: Hypothermia, Spinal Cord Injuries, Tissue Engineering

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