大鼠脑出血模型血肿周围继发损害及超微结构变化研究

Secondary injury to perihematoma in intracerebral haemorrhage rats

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、2 4h、48h、72h及 7d 7个小组 ;对照组分成 3h、2 4h及 72h 3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 2 4h ,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。

ObjectiveTo study possible mechanism through investigating the pathological and ultrastructural characters of secondary injury to perihematoma in intracerebral haemorrhage (ICH) rats.MethodsSprague Dawley 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 into 7 subgroups at 1 h, 3 h, 12 h, 24 h, 48 h, 72 h and 7 d after ICH; while those in control group were divided into 3 subgroups at 3 h, 24 h, 72 h after saline injection. Each subgroup contained 5 rats. 2 rats from each group were stained by 2% triphenyltetrazolium chloride(TTC) to observe the pathological change.3 rats were picked up from each group to do optical microscope and electric microscope investigation on perihematoma tissue and ipsilateral cortex.ResultsHematoma tissue was demonstrated as black brown 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 hyperplasia around hematoma with foot plate swollen were detected, no remarkable neural cells change was observed. 24 h after blood injection, astrocytes started to swell, part of them became degenerated and necrosis. Neural cells appeared mild degenerated and blood brain barrier were destroyed. 72 h after ICH, astrocytes showed highly swollen with neural cells degenerated.ConclusionSecondary injury to perihematoma has been identified and the pathological and ultrastructural changes have been observed.