脑创伤是一种严重的创伤，在年轻人中容易发生，可导致死亡和严重神经功能障碍。呼吸氢气通过选择性抗氧化治疗疾病，脑创伤的病理生理过程中也与氧化损伤关系密切。来自中国第四军医大学西京医院神经外科的研究表明，呼吸氢气能有效治疗大鼠脑创伤，该研究给氢气方法是在损伤后5分钟到5小时连续呼吸2%的氢气，通过检测脑水肿、血脑屏障、神经功能和损伤体积等指标，研究结果发现，呼吸氢气对脑创伤的治疗效果明显。通过对抗氧化酶和氧化损伤指标的检测发现，氢气能增加脑组织抗氧化能力，减轻脑创伤后脑组织氧化损伤。研究提示，呼吸氢气可通过减轻氧化应激改善脑创伤程度。给临床治疗该疾病提供了一个重要思路。这个文章也是中国的第17篇论著（见氢气全部文献汇编）。

评价，第四军医大学西京医院麻醉科已经发表了2篇呼吸氢气治疗系统炎症方面的文章，本文章是其第三篇论文，从研究思路上，尽管模型是新的，研究的手段没有特别。研究手段包括，采用Evans Blue测定血脑屏障、干湿比测定含水量、行为学检测运动能力、SOD， CAT，MDA等检测氧化指标，可以说简单便宜，估计总经费不超过1万元就可以做出来了。

显然该研究可以从炎症角度（测定各种因子和一些信号分子）、细胞碉亡角度（形态学、蛋白或活性检测）进行扩展。从血脑屏障角度，可以从检测血脑屏障方法（IgG）相关因子（MMP水通道等）。从氧化应激角度，可以从内质网应激角度深入。也可以从兴奋毒性角度检测各种神经递质水平。总之，想象的空间很大。这个工作与长征医院麻醉科关于脊髓损伤的研究可以形成对应，都属于中枢神经系统创伤类的研究。

Beneficial effects of hydrogen gas in a rat model of traumatic brain injury via reducing oxidative stress

Xituan Ji^{a, 1}, Wenbo Liu^{a, 1}, Keliang Xie^{b, 1}, Weiping Liu^a, Yan Qu^a, Xiaodong Chao^a, Tao Chen^a, Jun Zhou^c and Zhou Fei^{a, ,}

^a Department of Neurosurgery, Xijing Institute of Clinical Neuroscience, Xiing Hospital, Fourth Military Medical University, Xi'an 710032, Shaanxi Province, P. R. China

^b Department of Anesthesiology, General Hospital of Tianjin Medical University, Tianjin 300052, P. R. China

^c Department of Pharmacy, Urumqi General Hospital of PLA, Urumqi 830000, P. R. China

Accepted 14 July 2010. 

Available online 21 July 2010.

Abstract

Traumatic brain injury (TBI) is a leading cause of mortality and disability among the young population. It has been shown that hydrogen gas (H₂) exerts a therapeutic antioxidant activity by selectively reducing hydroxyl radical (•OH, the most cytotoxic ROS). Recently, we have found that H₂ inhalation significantly improved the survival rate and organ damage of septic mice. In the present study, we investigated the effectiveness of H₂ therapy on brain edema, blood-brain barrier (BBB) breakdown, neurological dysfunction and injury volume in TBI-challenged rats. In addition, we investigated the effects of H₂ treatment on the changes of oxidative products and antioxidant enzymes in brain tissue of TBI-challenged rats. Hydrogen treatment was given by exposure to 2% H₂ from 5 minutes to 5 hours after sham or TBI operation, respectively. Here, we found that TBI-challenged rats showed significant brain injuries characterized by the increase of BBB permeability, brain edema and lesion volume as well as neurological dysfunction, which was significantly attenuated by 2% H₂ treatment. In addition, we found that the decrease of oxidative products and the increase of endogenous antioxidant enzymatic activities in brain tissue may be associated with the protective effects of H₂ treatment in TBI-challenged rats. The present study supports that H₂ inhalation may be a more effective therapeutic strategy for patients with TBI.

Keywords: Traumatic brain injury (TBI); reactive oxygen species (ROS); oxidative stress; hydrogen gas

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