水蛭素对大鼠实验性脑出血急性期保护作用的研究

Protective effects of hirudin on acute experimental intracerebral hemorrhage

目的:通过观察凝血酶特异性抑制剂-水蛭素对脑出血后血肿周围组织胶质纤维酸性蛋白(GFAP)表达及脑组织含水量变化的影响,探讨水蛭素在脑出血后继发性损伤中的保护作用。方法:采用自体未抗凝动脉血注入法,制作实验性脑出血动物模型。将大鼠随机分为正常对照组,脑出血组,水蛭素组。光镜下定性观察脑出血后血肿周围组织的病理变化;采用干湿比重法定量测定脑组织含水量;免疫组化染色观察脑出血后GFAP的变化。结果:光镜示从脑出血后6 h开始血肿周围组织水肿进行性加重,3 d达高峰。脑出血后脑组织含水量逐渐增加,从1 d开始增加显著(P<0.05),3 d达高峰,7 d较3 d组虽有所下降,但与正常对照组相比差异显著。脑出血后1 dGFAP表达明显增强,随后持续增加,7 d达高峰。水蛭素组较相同时间点脑出血组血肿周围组织病理损伤减轻;脑组织含水量降低(P<0.05);GFAP表达有所下降(P<0.05)。直线回归分析表明,脑出血后1周内GFAP的变化与脑组织含水量变化呈正相关关系。结论:脑出血后1周内血肿局部应用凝血酶特异性抑制剂-水蛭素具有保护作用,并为脑出血的治疗提供一种新的给药途径。

Objective： To explore the protective effects of hirudin on acute experimental intracerebral hemorrhage （ICH） by observing the changes of histologic pathology and brain water content as well as GFAP-positive cells in the perihematomal brain regions. Method： The models of rat ICH were made with infusion of autologous blood into the right neucleus caudatus. The rats were divided randomly into control group, intracerebml hemorrhage group and treating group with hirudin. Brain water content was measured, and pathological and GFAP changes were old,erred, Result： The pathological impairation after ICH were gradually deteriorated and peaked at the third day. Brain water content after ICH was gradually increased and obviously after one day（ P 〈0.05） and peaked at the third day. GFAP-positive cells were gradually increased and peaked at the seventh day after ICH. In the treating groups, the pathological impairation and brain water content as well as the GFAP-positive cells were decreased as compared to those in the intracerebral hemorrhage group and the control group. And the positive correlation between GFAP-positive cell numbers and brain water content were shown by linear regression. Conclusion： The local administration of hirudin, a special inhibitor of thrombin, has protective effects within the first week after ICH.