脑出血后的病理改变与T淋巴细胞反应

The pathologic changes and T-lymphocyte reactions after cerebral hemorrhage in rats

目的:探讨脑出血血肿周围局部病理改变及细胞免疫机制。方法:用免疫组化方法及组织HE染色法观察20只大鼠尾壳核脑出血24 h,3天、7天血肿周围区域的组织病变及CD3+、CD8+T淋巴细胞的分布形式和表达时程。结果:①在脑出血后24 h血肿周围即可见明显血管源性水肿,大量炎性细胞浸润,以中性粒细胞为主,少量散在淋巴细胞、小胶质细胞、星形细胞、少突胶质细胞弥漫浸润;出血3天、7天以淋巴细胞、巨噬细胞浸润为主,小胶质细胞、星形细胞、少突胶质细胞增生明显,双侧半球皮层下和血管周围出现小胶质细胞结节;②出血灶周围CD3+和CD8+T淋巴细胞浸润在出血后24 h已可见,出血后3天组和出血后7天组,CD3+和CD8+阳性细胞数明显高于出血后24 h组。结论:①脑出血期以中性粒细胞反应为主,以后以淋巴细胞反应为主,胶质细胞反应在出血后24 h已发生,持续一周以上;②CD3+、CD8+阳性细胞的出现提示它们参与了出血后脑损伤的病理过程,在出血7天内, CD3+和CD8-阳性细胞反应呈增强趋势。

Objective：To explore pathological Changes of cell immunity mechanism of hematoma surrounding tissues after acute cerebral hemorrhage in rats. Methods： By staining methods of immunochemisty and pathology , to investigate the pathological changes and CD3^＋ or CD8^＋ lymphocytes expression and distribution in hematoma surrounding tissues at the 24^th hour , 3rd and 7^th day after hemorrhage of chilincaudal nucleus in rats. Results：At the 24^th hour after cerebral hemorrhage, a large number of inflammatory cells infiltration and cerebral edema appeared. On the 3rd and 7^th day , a large number of lymphocytes and macrophago cytes appeared. At the 24^th hour after hemorrhage , the CD3^＋ and CD8^＋ T lymphocytes were shown. But the number of positive cells increased on the 3rd and 7^th day in comparison with those at the 24^th hour after hemorrhage . Conclusions：In the early stage of hemorrhage, the neutrophil infiltration is a main inflammatory process, but the positive lymphacytes and macrphages infiltration are severe on the 3rd and 7^th day. The CD3^＋ and CD8^＋ positive cells have participated in the pathological process after cerebral hemorrhage.