脑出血病人神经元凋亡及Bcl-2、Bax表达与中风闭脱证的研究

The Relationship Among Neural Apoptosis and Expression of Bcl-2,Bax in Intracerebral Hemorrhage

目的观察脑出血病人血肿周围组织神经元凋亡和凋亡相关基因Bcl-2、Bax蛋白的表达及其与中风闭脱证的关系。方法采用TUNEL法、免疫组织化学法分别检测脑出血病人血肿周围组织凋亡神经元和Bcl-2、Bax蛋白表达水平。结果血肿周围组织细胞凋亡率及Bcl-2、Bax蛋白表达明显高于正常对照组,差异有统计学意义(P<0.01);Bcl-2蛋白表达与细胞凋亡率呈负相关(P<0.01),Bax蛋白表达及Bax/Bcl-2与细胞凋亡率呈正相关(P均<0.01)。闭、脱证之间细胞凋亡率及Bcl-2、Bax蛋白阳性率、Bax/Bcl-2有统计学意义(P<0.05或P<0.01),脱证细胞凋亡率、Bax、Bax/Bcl-2大于闭证,Bcl-2小于闭证。结论细胞凋亡机制参与了脑出血后继发性神经元损伤。细胞凋亡率及Bcl-2、Bax蛋白表达对中风闭脱证微观辨证有一定的帮助。

Objectives To observe neural apoptosis and the expression of Bcl - 2, bax protein in the perihematomal brain region in patients with intracerebral hemorrhage （ICH） ,and the relationship between neural apoptosis, the expression of Bcl- 2,Bax protein and Sthenia Zheng, Prostration Zheng. Methods The apoptosis of perihematomal brain tissue were examined with TUNEL method and the Bcl- 2,bax gene expression was detected with Immunohistochemical method in 29 patients（pts） with ICH. Results The apoptosis rate and the expression of Bcl- 2, bax protein in the perihematomal brain region in pts with ICH increased significantly in comparison with the normal control groups （P 〈 0.01 ）. The expression rate of Bcl - 2 protein showed obvious negative correlation to the apoptosis rate （P 〈 0.01 ）. The expression rate of bax protein and the Bax/Bcl - 2 ration showed obvious positive correlation to the apoptosis rate in perihematomal brain region of pts with ICH （P ＜ 0.01 ）. The apoptosis rate and the expression rate of Bcl - 2, bax protein, Bax/Bcl - 2 ration were different significantly among sthenia and the prostration zheng（P ＜ 0.01 - ＜ 0.05）.The apoptosis rate, the expression rate of bax protein and Bax/Bcl - 2 ration of prostration Zheng was higher than sthenia; the expression rate of Bcl- 2 protein in sthenia was higher than that in prostration Zheng. Conclusion The mechanism of apoptosis may be involved in the delayed brain injury after ICH in human. The apoptosis rate and the expression rate of Bcl - 2, Bax protein in the perihematomal brain region of pts with ICH could serve as a microcosmic index to judge the difference between stroke sthenia and prostration zheng.