大鼠脑出血模型血肿周围继发损害及超微结构变化研究

・基础研究・大鼠脑出血模型血肿周围继发损害及超微结构变化研究

赵性泉　周剑　王拥军

[摘要]目的探讨脑出血所引发的血肿周围组织继发性损害的病理生理过程和可能机制。方法制备SD雄性大鼠脑出血模型,实验组分成1h、3h、12h、24h、48h、72h及7d7个小组;对照组分成3h、24h及72h3个小组,每组5只大鼠。每实验小组取2只大鼠,2%氯四氮唑(TTC)染色,进行大体组织病理演变观察。另取3只大鼠,在血肿周边区及同侧皮层区分别取脑组织在透射电子显微镜及光学显微镜下观察。结果TTC染色显示,血肿呈黑褐色,血肿周围未见白色梗死区。光镜下观察,血肿区与正常脑组织间有一周围区,其中可见组织疏松,细胞不同程度水肿,星形细胞肿胀,神经细胞变性、坏死,出血灶周边毛细血管增生伴炎细胞浸润。电镜观察可见,血肿周围组织早期星形细胞胞体和周边足突肿胀,神经细胞改变不明显。注血后24h,星形细胞肿胀明显,部分变性、坏死;神经细胞轻度变性,血脑屏障破坏。注血后72h,星形细胞高度肿胀,神经细胞变性。结论脑出血血肿周围脑组织发生病理、超微结构的改变,血肿周围脑组织产生继发性损害。

[关键词]脑出血;脑水肿;电子显微镜;病理;大鼠

Second ary injury to perihem atom a in intracerebral haemorrhage rats ZHA O Xing2quan,ZHOU Jian,W A N G Yong2jun.Depart ment of Neurology,Beijing Tiantan Hospital,Beijing100050,China

[Abstract]Objective To study possible mechanism through investigating the pathological and ultrastructural characters of secondary injury to perihematoma in intracerebral haemorrhage(ICH)rats.Methods Sprague2Dawley male rats were subjected to ICH models.They were randomly divided into test group and control group.The rats in the test group were divided into7subgroups at1h,3h,12h,24h, 48h,72h and7d after ICH;while those in control group were divided into3subgroups at3h,24h,72h after saline injection.Each subgroup contained5rats.2rats from each group were stained by2%triphenyltetrazolium chloride(TTC)to observe the pathological change.3rats were picked up from each group to do optical microscope and electric microscope investigation on perihematoma tissue and ip2 silateral cortex.R esults Hematoma tissue was demonstrated as black2brown by TTC staining,no white infarcted area was detected around hematoma.In addition,there was a transitional zone between hematoma and normal tissue under microscopy;the involved tissue looked loose with varied edematous cells.Astrocytes appeared swollen and neural cells looked degenerated and necrosis.Meanwhile,capillary hy2 perplasia around hematoma with foot2plate swollen were detected,no remarkable neural cells change was observed.24h after blood injec2 tion,astrocytes started to swell,part of them became degenerated and necrosis.Neural cells appeared mild degenerated and blood2brain bar2 rier were destroyed.72h after ICH,astrocytes showed highly swollen with neural cells degenerated.Conclusion Secondary injury to perihe2 matoma has been identified and the pathological and ultrastructural changes have been observed.

[K ey w ords]intracerebral haemorrhage;cerebral edema;electric microscope;pathology;rat

中图分类号:R743.34文献标识码:A文章编号:100629771(2004)0820469203

[本文著录格式]　赵性泉,周剑,王拥军.大鼠脑出血模型血肿周围继发损害及超微结构变化研究[J].中国康复理论与实践, 2004,10(8):469—471.

脑出血是一种发病率很高的急性脑血管病,至今仍无特别有效的治疗方法[1]。脑出血后,血肿周围存在一个组织损伤和水肿形成进行性加重的区域,该区域内的病理改变在一定时间内是可逆性的,如果能在此时间窗内给予适当的治疗措施,可使受损组织恢复功能,此区域称血肿周边半影区或半暗带[2]。挽救脑出血后血肿周边半影区内潜在可逆性损伤脑组织是近几年来脑出血研究的重点[325]。本研究通过大鼠脑出血模型观察血肿周围继发性损害的病理过程和超微结构的改变,以期进一步明确脑实质出血所引发的周围组织继发性损伤的病理生理过程和可能的机制。

1材料与方法

作者单位:1.100050北京市,首都医科大学附属北京天坛医院神经内科(赵性泉,王拥军);2.100050北京市,武警总医院影像科(周剑)。作者简介:赵性泉(19672),男,山东郓城县人,副主任医师,主要研究方向:神经病学。1.1实验动物及分组　健康成年雄性Sprague2Dawley 大鼠(由中国医学科学院动物室提供)50只,体重300—350g。采用随机数字抽样法将大鼠分为实验组和对照组,实验组分成1h、3h、12h、24h、48h、72h 及7d7个小组;对照组分成3h、24h及72h3个小组,每小组5只大鼠。

1.2脑出血模型制备　在2次注血法制备脑出血模型基础上进行改良,采用1次低压、缓慢注血法制备大鼠脑出血模型。对照组注入等量生理盐水,手术过程同实验组。

1.3标本及病理切片制作　每实验小组取3只大鼠行心脏插管、4%多聚甲醛(p H7.4)灌流固定,断头取脑,于尾状核血肿周边区及同侧皮层区分别取1mm3脑组织2块,置于

2.5%戊二醛溶液中固定;逐级脱水、包埋、切片、铅铀染色,透射电子显微镜(简称电镜)下观察。将剩余脑组织置于4%多聚甲醛溶液中固定,脱水、透明、石蜡包埋、组织切片及HE染色,在光学显