87例大脑及脑干挫伤HSP70变化的研究

An immunohistochemical study on changes of HSP70 in cerebral and brainstem contusion in 87 human cases

目的探讨人大脑及脑干挫伤后神经细胞HSP70变化与损伤时间的关系及大脑与脑干HSP70变化的差异。方法对87例闭合性颅脑损伤死亡脑挫伤组织进行病理学及HSP70免疫组织化学染色,结果进行图像分析。结果脑挫伤24h后.HSP70阳性神经细胞最多见,且免疫反应性最强,随后逐渐下降,14d组及30d组HSP70表达与对照组类似。脑挫伤部位可见较多HSP70阳性的淀粉样小体。图像分析显示大脑与脑干HSP70阳性细胞3个参数(A、IOD及AOD)之间呈高度显著正相关或显著正相关,由高至低排列为:A>IOD>AOD。结论神经细胞HSP70免疫组化染色结合图像分析技术作为推断脑挫伤经过时间的参考,大脑与脑干挫伤后神经细胞HSP70变化规律基本一致,但脑挫伤灶周围淀粉样小体形成的意义有待于进一步研究。

Objective To study the relationships of changes of HSP70 with the posttraumatic intervals after the cerebral and brain stem contusion in human and compare the difference of the HSPT0 expression in the cerebral contusion with that in the brainstem contusion. Methods Samples of confirmed cerebral contusion were collected from 87 cases with closed head injury. Conventional histological H. E staining and immunostaing of HSPT0 were performed. The immunostaining results were analyzed by image analysis technique. Results The number of the HSP70 - positive cells peaked at 24h after the injury, and thereafter declined gradually. The numbers of the HSP70 - positive cells at the 14d and 30d posttrauma were similar to those of the control cases. The HSP70 - stained corpora amylacea were detected at the sites of the brain contusion. The image analysis of the HSP70 -positive cells was made and three indices （A, IOD, AOD） were significantly correlated with a descending order of A 〉 IOD 〉 AOD. Conclusion Detection of HSP70 by immunohistochemical staining in combination with image analysis technique could be used for estimation of the posttraumatic interval of the brain contusion. The temporal changes of the HSP70 - positive cells in both the cerebral contusion and brainstem contusion revealed similarity. The HSP70 -stained corpora amylacea at the sites of the brain contusion needs to be studied further.