立体定向血肿抽吸对大鼠脑出血细胞凋亡的影响

Interference Effects of Invasive Hematoma Aspiration on the Apoptosis after Intracerebral Hemorrhage in Rats

[目的]探讨大鼠脑出血双侧纹状体区细胞凋亡的时程变化规律和早期立体定向血肿抽吸术干预治疗对细胞凋亡的影响.[方法]雄性Sprague-Dawley(SD)大鼠80只,随机分成正常对照组,假手术组,脑出血自然恢复组,6 h血肿抽吸组,12 h血肿抽吸组以及24 h血肿抽吸组.采用立体定向注入Ⅶ型胶原酶建立脑出血模型.采用原位末端标记法检测出血周边组织细胞的凋亡.[结果]①大鼠脑出血周边组织12 h出现凋亡细胞,3d凋亡细胞达峰值,11 d仍有凋亡细胞表达.②血肿抽吸术干预后出血周边组织凋亡细胞数与脑出血组对应时间点比较显著下降(P<0.05).③6 h血肿抽吸组与24 h血肿抽吸组比较细胞凋亡数明显低于24 h血肿抽吸组,差异有显著性(P<0.05).[结论]立体定向血肿抽吸术干预治疗大鼠脑出血可明显影响细胞凋亡的表达,脑出血各种临床治疗的“时间窗”应为出血后12 h之内.早期(6 h)立体定向血肿抽吸术治疗可以显著减少脑出血后细胞凋亡.

[ Objective ] To investigate the changes of apoptosis expression with time in bilateral cerebral striatum of rats caused by intracorebral hemomhage （ICH） and the influence of early treatment with hematoma aspiration on apoptosis. [ Methods ] In this experiment 80 mature male Sprague-Dawley rats were randomly divided into normal control group, false operation group, natural recovery group and 6 hour. 12 hour,24 hour hematoma aspiration group. Establishment of cerebral hemorrage ： Intraeerebral hemorrhage was induced by injection of bacterial collagenase. The apoptotic cells in brain tissues were measured by TUNEL method. [ Results]（1）The apoptosis around hematoma on ICH w as detected at 12 h, with its peak at 3 d there was the expression of apoptosis, until 11 d ;（2）The apoptosis cells were significantly decreased at the corresponding time after aspiration interfere compared with ICH group （ P 〈 0. 05 ） ; （3）The apoptosis cells of 6 hour hematoma aspiration group was less than that of 24 hour hematoma aspiration group, and the difference was significant （ P 〈 0. 05）. [ Conclusion ] The apoptosis was markedly influenced by stereotaxis hematoma aspiration after ICH in rat. The time window of clinical treatment should be in the 12 hour after ICH. Early （6 h） hematoma aspiration is effective.