《中国康复理论与实践》

中国康复理论与实践 >

2018 , Vol. 24 >Issue 4: 373 - 377

DOI: https://doi.org/10.3969/j.issn.1006-9771.2018.04.001

专题:中枢神经损伤后水肿的机制及干预

脱水剂在急性脊髓损伤中的应用进展

  • 张超 ,
  • 李建军 ,
  • 杨德刚 ,
  • 杨明亮 ,
  • 杜良杰 ,
  • 张文豪 ,
  • 刘长彬 ,
  • 李大鹏 ,
  • 胡安明 ,
  • 秦川
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  • 1.首都医科大学康复医学院,北京市 100068;
    2.中国康复研究中心北京博爱医院,a.脊柱脊髓神经功能重建科;
    b.神经外科,北京市 100068;
    3.北京脑重大疾病研究院神经损伤与修复研究所,北京市 100068;
    4.北京市神经损伤与康复重点实验室,北京市 100068
张超(1989-),男,汉族,山东临沂市人,博士研究生,主要研究方向：脊柱脊髓损伤的康复与治疗。

收稿日期: 2017-12-18

  修回日期: 2018-01-27

  网络出版日期: 2018-04-27

基金资助

1.中央级公益性科研院所基本科研业务费专项资金项目(No. 2016CZ-4); 2.中国康复研究中心课题(No. 2012-1; No. 2013-7)

收起

Application Progress of Dehydrating Agent in Acute Spinal Cord Injury (review)

  • ZHANG Chao ,
  • LI Jian-jun ,
  • YANG De-gang ,
  • YANG Ming-liang ,
  • DU Liang-jie ,
  • ZHANG Wen-hao ,
  • LIU Chang-bin ,
  • LI Da-peng ,
  • HU An-ming ,
  • QIN Chuan
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  • 1. Capital Medical University School of Rehabilitation Medicine, Beijing 100068, China;
    2. a. Department of Spinal and Neural Function Reconstruction, b. Department of Neurosurgery, Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing 100068, China;
    3. Center of Neural Injury and Repair, Beijing Institute for Brain Disorders, Beijing 100068, China;
    4.Beijing Key Laboratory of Neural Injury and Rehabilitation, Beijing 100068, China

Received date: 2017-12-18

  Revised date: 2018-01-27

  Online published: 2018-04-27

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摘要

急性脊髓损伤(ASCI)可分为原发性损伤和继发性损伤。脊髓水肿对脊髓继发性损伤的发展至关重要。脊髓水肿主要分为细胞毒性水肿和血管源性水肿。脱水剂在ASCI后水肿的治疗中作用明显。本文主要介绍甘露醇、高渗盐水、甘油果糖、呋塞米、人血白蛋白、白藜芦醇等脱水剂在ASCI治疗中的应用进展。

关键词： 脊髓损伤; 水肿; 脱水剂; 综述

本文引用格式

张超 , 李建军 , 杨德刚 , 杨明亮 , 杜良杰 , 张文豪 , 刘长彬 , 李大鹏 , 胡安明 , 秦川 . 脱水剂在急性脊髓损伤中的应用进展[J]. 中国康复理论与实践, 2018 , 24(4) : 373 -377 . DOI: 10.3969/j.issn.1006-9771.2018.04.001

Abstract

Acute spinal cord injury (ASCI) can be divided into primary injury and secondary injury. Spinal cord edema is important for the development of secondary injury after ASCI. Spinal cord edema can be mainly divided into cytotoxic edema and angioedema. The application of dehydrating agents in the treatment of acute spinal cord injury is obvious. This article described the application of mannitol, hypertonic saline, glycerol fructose, furosemide, human serum albumin, resveratrol and other dehydrating agents in the treatment of ASCI.

Key words： spinal cord injury; edema; dehydrating agent; review

参考文献

[1] Wang H, Liu X, Zhao Y, et al.Incidence and pattern of traumatic spinal fractures and associated spinal cord injury resulting from motor vehicle collisions in China over 11 years: an observational study[J]. Medicine (Baltimore), 2016, 95(43): e5220.
[2] Yang R, Guo L, Wang P, et al.Epidemiology of spinal cord injuries and risk factors for complete injuries in Guangdong, China: a retrospective study[J]. PLoS One, 2014, 9(1): e84733.
[3] Jain NB, Ayers GD, Peterson EN, et al.Traumatic spinal cord injury in the United States, 1993-2012[J]. JAMA, 2015, 313(22): 2236-2243.
[4] Dasari VR, Veeravalli KK, Dinh DH.Mesenchymal stem cells in the treatment of spinal cord injuries: a review[J]. World J Stem Cells, 2014, 6(2): 120-133.
[5] Zhu TM, Tang QS, Gao HS, et al.Current status of cell-mediated regenerative therapies for human spinal cord injury[J]. Neurosci Bull, 2014, 30(4): 671-682.
[6] Poniatowski ŁA, Wojdasiewicz P, Krawczyk M, et al.Analysis of the role of CX3CL1 (Fractalkine) and its receptor CX3CR1 in traumatic brain and spinal cord injury: insight into recent advances in actions of neurochemokine agents[J]. Mol Neurobiol, 2017, 54(3): 2167-2188.
[7] Xu M, Wang HF, Zhang YY, et al.Protection of rats spinal cord ischemia-reperfusion injury by inhibition of MiR-497 on inflammation and apoptosis: possible role in pediatrics[J]. Biomed Pharmacotherapy, 2016, 81: 337-344.
[8] 张文豪,李建军,杨德刚,等. MicroRNA在脊髓损伤中的研究进展[J].中国康复理论与实践, 2017, 23(6): 649-653.
[9] 曾智谋,张寿,刘亦恒,等. 脊髓损伤的病理生理及治疗进展[J]. 海南医学, 2013, 24(14): 2105-2108.
[10] Winkler EA, Sengillo JD, Bell RD, et al.Blood-spinal cord barrier pericyte reductions contribute to increased capillary permeability[J]. J Cereb Blood Flow Metab, 2012, 32(10): 1841-1852.
[11] 张鑫,李建军,杨德刚,等. 脊髓损伤后髓内压测量方法的研究进展[J]. 中国康复理论与实践, 2017, 23(8): 919-923.
[12] 王东旭,许卫兵. 水通道蛋白与脊髓水肿的研究进展[J]. 脊柱外科杂志, 2015, 13(4): 250-253.
[13] Leonard AV, Thornton E, Vink R, et al.NK1 receptor blockade is ineffective in improving outcome following a balloon compression model of spinal cord injury[J]. PLoS One, 2014, 9(5): e98364.
[14] 冯学伟. 探讨脊柱脊髓损伤的现代康复治疗[J]. 临床医药文献电子杂志, 2017, 4(6): 1188.
[15] 田野. 成人无骨折脱位型颈脊髓损伤最新治疗进展研究[J]. 科技展望, 2017, 27(6): 278.
[16] 莫仕安. 脊髓损伤的治疗现状和进展[J]. 医学信息, 2015, 28(7): 28.
[17] Boone MD, Oren-Grinberg A, Robinson TM, et al.Mannitol or hypertonic saline in the setting of traumatic brain injury: What have we learned?[J]. Surg Neurol Int, 2015, 6: 177.
[18] 弓立群,徐洪海,常彦海,等. 脊髓损伤早期药物治疗临床观察[J]. 陕西医学杂志2000, 29(9): 543-545.
[19] Baysefer A, Erdogan E, Kahraman S, et al.Effect of mannitol in experimental spinal cord injury:an ultrastructural and electrophysiological study[J]. Neurol India, 2003, 51(3): 350-354.
[20] 李顺国,王猛. 继发性脊髓损伤的药物治疗进展[J]. 现代医药卫生, 2015, 31(3): 368-371.
[21] Tyagi R, Donaldson K, Loftus CM, et al.Hypertonie saline: a clinical review[J]. Neurosurgical Rev, 2007, 30(4): 277-289.
[22] 李功波,梁君,潘昕,等. 脱水剂在神经外科中的临床应用及研究进展[J]. 徐州医学院学报, 2017, 37(2): 131-135.
[23] 杨伟科. 人血白蛋白联合甘露醇及呋塞米治疗重度颅脑损伤疗效分析[J]. 中国实用神经疾病杂志, 2015, 18(3): 107.
[24] 王丽泉,侯庆先,袁宏. 甘油果糖与甘露醇治疗脑水肿的临床疗效比较[J]. 中国医药导报, 2007, 4(30): 136.
[25] 郭宏伟,黄磊,刘雪芳,等. 托拉塞米与呋塞米对急性脑出血患者脑水肿影响的对比研究[J].中华老年心脑血管病杂志, 2012, 14(8): 838-841.
[26] 杨迎暴,朴英杰. 白藜芦醇对脊髓损伤后继发性脊髓水肿,乳酸脱氢酶及ATP酶活性的影响[J]. 中国药理学通报, 2002, 18(5): 539-543.
[27] 何珏,王千科. 丙泊酚干预脊髓损伤模型脊髓水肿及后肢电生理的变化[J]. 中国组织工程研究, 2016, 20(5): 640-645.
[28] 周敬涛. 甘露醇的作用机理及临床应用[J]. 中外健康文摘, 2010, 7(31): 237.
[29] 曲友直,赵振伟,高国栋. 甘露醇对局灶性脑缺血再灌注大鼠脑组织 NO及神经细胞凋亡的影响[J]. 卒中与神经疾病, 2004, 11(1): 8-9.
[30] Nout YS, Mihai G, Tovar CA, et al.Hypertonic saline attenuates cord swelling and edema in experimental spinal cord injury: A study utilizing magnetic resonance imaging[J]. Crit Care Med, 2009, 37(7): 2160-2166.
[31] 余国龙,欧雅莉,杨天伦. 甘露醇促进脐带血CD34+细胞通过血脑屏障迁移至高血压脑梗死大鼠脑组织[J]. 中国组织工程研究与临床康复, 2011, 15(27): 5068-5071.
[32] Ikeda M, Bhattacharjee AK, Kondoh T, et al.Synergistic effect of cold mannitol and Na(+)/Ca(2+) exchange blocker on blood-brain barrier opening[J]. Biochem Biophys Res Commun, 2002, 291(3): 669-674.
[33] 刘金萍,莫雪安,杨龙秀. 甘露醇预处理后骨髓间充质干细胞移植对血管性痴呆大鼠认知功能及脑源性神经生长因子表达的影响[J].中国脑血管病杂志, 2011, 8(5): 253-258.
[34] Lu TS, Chen HW, Huang MH, et al.Heat shock treatment protects osmotic stress -induced dysfunction of the blood-brain barrier through preservation of tight junction proteins[J]. Cell Stress Chaperones, 2004, 9(4): 369-377.
[35] 贾旺,于春江,王凤梅,等. 不同药物治疗创伤性脑水肿的动物实验研究[J]. 首都医科大学学报, 2001, 22(3): 216-219.
[36] Zeng HK, Wang QS, Deng YY, et al.A comparative study on the efficacy of 10% hypertonic saline and equal volume of 20% mannitol in the treatment of experimentally induced cerebral edema in adult rats[J]. BMC Neurosciences, 2010, 11(1): 153.
[37] 苗丽霞,何本让,田金飞,等. 蛛网膜下腔出血患者应用甘露醇致急性肾损害的临床分析[J]. 中国基层医药, 2012, 19(13): 2010-2011.
[38] 方奕,武晓春. 甘露醇致急性肾损伤56例临床分析[J]. 中西医结合心脑血管病杂志, 2008, 6(12): 1511-1512.
[39] Kim MY, Park JH, Kang NR, et al.Increased risk of acute kidney injury associated with higher infusion rate of mannitol in patients with intracranial hemorrhage[J]. J Neurosurg, 2014, 120(6): 1340-1348.
[40] Mortazavi MM, Romeo AK, Deep A, et al.Hypertonic saline for treating raised intracranial pressure: literature review with meta-analysis[J]. J Neurosurgical, 2012, 116(1): 210-221.
[41] Scalfani MT, Dhar R, Zazulia AR, et al. Effect of osmotic agents on regional cerebral blood flow in traumatic brain injury [J]. J Crit Care, 2012, 27(5): 526. e7-12.
[42] Michinaga S, Koyama Y.Pathogenesis of brain edema and investigation into anti-edema drugs[J]. Int J Mol Sci, 2015, 16(5): 9949-9975.
[43] Pinto FC, Capone-Neto A, Prist R, et al.Volume replacement with lactated Ringer's or 3% hypertonic saline solution during combined experimental hemorrhagic shock and traumatic brain injury[J]. J Trauma, 2006, 60(4): 758-763.
[44] Forsyth LL, Liu-Deryke X, Parker D Jr, et al.Role of hypertonic saline for the management of intracranial hypertension after stroke and traumatic brain injury[J]. Pharmacotherapy, 2008, 28(4): 469-484.
[45] Ziai WC, Toung TJ, Bhardwaj A.Hypertonic saline: first-line therapy for cerebral edema?[J]. J Neurol Sci, 2007, 261(1-2): 157.
[46] Baker AJ, Park E, Hare GM, et al.Effects of resuscitation fluid on neurologic physiology after cerebral trauma and hemorrhage[J]. J Trauma, 2008, 64(2): 348-357.
[47] De Vivo P, Del Gaudio A, Ciritella P, et al.Hypertonic saline solution: a safe alternative to mannitol 18% in neurosurgery[J]. Minerva Anestesiol, 2001, 67(9): 603-611.
[48] Moore FA, McKinley BA, Moore EE. The next generation in shock resuscitation[J]. Lancet, 2004, 363(9425): 1988-1996.
[49] Velasco IT, Pontieri V, Rocha e Silva M Jr, et al. Hyperosmotic NaCl and severe hemorrhagic shock[J]. Am J Physiol, 1980, 239(5): 664-673.
[50] 王飞,于大鹏,赵廷宝. 急性颈脊髓损伤后低蛋白血症的病因和防治[J]. 实用医药杂志, 2015, 32(8): 682-685.
[51] 孙坚彤,顾雪英,赵中. 甘油果糖联合甘露醇治疗颅内高压的疗效观察及分析[J]. 中国医院药学杂志, 2011, 31(13): 1108-1110.
[52] Pearse DD, Sanchez AR, Pereira FC, et al.Transplantation of Schwann cells and/or olfactory ensheathing glia into the contused spinal cord: survival, migration, axon association, and functional recovery[J]. Glia, 2007, 55(9): 976-1000.
[53] Papastefanaki F, Chen J, Lavdas AA, et al.Grafts of Schwann cells engineered to express PSA-NCAM promote functional recovery after spinal cord injury[J]. Brain, 2007, 130(8): 2159-2174.
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