实验性脑出血大鼠脑水肿及其血肿周围组织形态学动态变化

Dynamic changes of brain edema and histomorphology in perihematoma in experimental intracerebral hemorrhage in rats

目的研究大鼠脑出血后脑水肿及其血肿周围组织形态学动态变化.方法应用立体定向技术,用大鼠自体股动脉血液100μl缓慢注入大鼠尾状核,制成脑出血模型,动态观察脑水肿及其血肿周围组织形态学变化.脑水肿的测定应用干/湿重法,血肿周围脑组织进行光学显微镜观察.结果脑出血血肿周围组织含水量与对照组有显著差别,出血侧脑组织含水量与出血对侧脑组织含水量间有显著差别,以出血后24～72 h最明显,至脑出血后第7天大致恢复正常.24 h出血侧基底节脑组织含水量为（77.80±0.53）%,出血对侧为（77.53±0.43）%;72 h出血侧基底节为（79.42±0.89）%,出血对侧为（77.64±0.34）%;假手术组手术侧基底节为（76.86±0.88）%,手术对侧为（76.89±0.87）%.血肿周围脑组织内部分神经元变性坏死;出血后6 h即可见少数单个散在炎性细胞浸润;24 b以中性粒细胞为主的炎性细胞浸润明显增加;72 h可见血肿周围及血肿内胶质细胞、血管增生;7 d时血肿明显缩小,胶质细胞及血管增生明显.结论大鼠脑出血后脑水肿改变与其血肿周围组织形态学动态变化一致,脑出血后的脑水肿及血肿周围的组织形态学变化是导致病情恶化的主要原因之一.

Objective To dynamically observe histomorphology and brain edema changes in perihematoma in intracerebral hemorrhage （ICH） model in rats. Methods A volume of hematoma was formed by stereotactic infusing 100μl autologous femoral artery blood into the right caudate nucleus. The histomorphologieal changes and brain edema of the model rats was measured dynamically. The brain tissue was immediately weighed hy dry/wet weight. Peribematoma tissues were collected for observation under light microscope. Results There were significant differences in brain water content between perihematoma tissue and controls and between the hemorrhage and non-hemorrhage sides of cerebral basal ganglia, especially during 24 - 72 hours after hemorrhage, recovering normal at the 7th day after ICH. The brain water volume were （77.80 - 0.53） % vs （77.53 - 0. 43） %, and （79.42 - 0.89） % vs （ 77.64 - 0.34） % in hemorrhage and non-hemorrhage sides of cerebral basal ganglia at the 24th and 72rid hour,while （76.86 ± 0.88 ） % vs （76.89 ± 0. 87） % in operated and non-operated sides in sham operation group. Some neurons in the perihematoma region displayed necrosis. Several scattered inflammatory ceils were observed in the perihematoma region at 6th hour after ICH and the inflammatory infiltration characterized by neutrophils increased markedly at 24th hour. At the 72nd hour after ICH gliosis and capillary hyperplasia were observed in and around hematoma. The area of hematoma reduced markedly,accompanied by distinct glial and capillary hyperplasia at the 7th day after ICH. Conclusions Brain edema regularity in rats could be corresponded well with histomorphological changes after ICH, which might be one of the direct causes of diseases deterioration.