脊髓损伤电位无创评估方法研究

In the early stage of spinal cord injury, traumas of axolemma will result in an injury potential which is characterized by influx of ions, and the injury potential is the quantitative index of injury degree. Our research has demonstrated that compensation for injury potential right after spinal cord injury can significantly inhibits the secondary injury and benefits the functional recovery of spinal cord. In animal experiments, compensation level depends on the measured injury potential degree with the vertebras opened, while a new way should be found to make this process more convenient and noninvasive if this method is going to be applied in clinic. Through our studies we noticed that there is a clear correlation between injury potential and evoked potential of spinal cord, so a noninvasive detection and evaluation method will be established only if the relationship of evoked potential between spinal cord and body surface is ensured. Base on this concept, the project will explores a noninvasive detection method of injury potential by electricity model simulation analysis, in vitro and in vivo experiments between injury potentials and evoked potentials. This method will not only provides a feedback control parameter to further clinical applications of compensation for injury potential, but also becomes a quantitative evaluation strategy of injury degree in the early stage of spinal cord injury as well, provides an objective reference index on early treatment or prognosis in clinic.

脊髓损伤早期，由于轴膜的破损会形成以离子内流为特征的损伤电位，而损伤电位是损伤程度的量化指标。我们的研究已经证明，早期损伤电位补偿可以显著抑制脊髓的继发性损伤，有利于后期脊髓功能的恢复。动物实验中，损伤电位补偿是以椎骨开放环境下检测到的损伤电位为反馈量进行补偿的，这种方法若想在临床上得到应用，必须找到一种能够便捷无创检测损伤电位的方法。我们通过实验发现，损伤电位与脊髓诱发电位之间具有明确的相关性，进一步找到体表诱发电位与脊髓诱发电位之间的相关性就能获得一种无创的脊髓损伤电位检测评估方法。基于此构想，本项目将通过损伤电位与诱发电位的电学模型仿真分析结合离体实验和在体实验，探索损伤电位的无创量化检测方法。这种方法的建立不仅可以为下一步损伤电位补偿的临床应用提供反馈控制参量，而且可以提供一种脊髓早期损伤程度量化评估的手段，为临床上脊髓损伤的早期处理及预后提供客观参考指标。

脊髓损伤早期，由于轴膜的破损会形成以离子内流为特征的损伤电位，而损伤电位是损伤程度的量化指标。本项目通过损伤电位与诱发电位的电学模型仿真分析结合离体实验和在体实验，探索了损伤电位的无创量化检测方法。在仿真分析中，我们依据损伤后诱发电位自发恢复的实验结果建立了具有自发修复因子的损伤电位模型，仿真结果更接近实际情况。在离体实验中，我们测量了不同损伤程度的诱发电位和损伤电位，根据实验结果建立了诱发电位与损伤电位之间的相关性，能够由离体诱发电位推算出离体损伤电位。在动物试验中，建立了脊髓损伤动物模型，分别采用有创的电刺激和无创的磁刺激方法测量了损伤前后的诱发电位，验证了离体实验中诱发电位与损伤电位的相关性。最后对实验方法进行总结和改进建立了无创脊髓损伤电位评估方法，这种方法的建立不仅可以为下一步损伤电位补偿的临床应用提供反馈控制参量，而且可以提供一种脊髓早期损伤程度量化评估的手段，为临床上脊髓损伤的早期处理及预后提供客观参考指标。