实验性脑出血高血糖与血肿周围乳酸和细胞因子关系的研究

Relationship of hyperglycemia after brain hemorrhage and lactic acid and cytokines around hematoma

目的观察大鼠脑出血后高血糖对血肿周围脑组织乳酸(LA)、细胞因子等指标的影响;探讨脑出血后高血糖致乳酸中毒加重脑损伤的可能机制。方法采用自体血注入法建立脑出血模型,将80只SD大鼠随机分成假手术组(5只)、单纯脑出血组(25只)、脑出血后高血糖A组(2g/kg,25只)和脑出血后高血糖B组(4g/kg,25只)。各组大鼠于术后1、3、7、10、14d测血肿周围脑组织LA、IL-1β、TNF-α的含量变化。结果与假手术组比较,脑出血3组大鼠血肿周围脑组织LA、IL-1β和TNF-α含量明显升高(P<0.05);与单纯脑出血组比较高血糖A组和B组大鼠术后血肿周围脑组织LA、IL-1β和TNF-α含量明显升高(P<0.05),以高血糖B组升高更显著。结论提示脑出血后高血糖导致能量代谢障碍,LA蓄积中毒,可能通过增强炎症反应加重脑损伤。

Objective To observe the influence of hyperglycemia to lactic acid（LA）and cytokines around hematoma of rats after intracerebral hemorrhage,and to discuss the possible damaging mechanism of lactic acidosis caused by hyperglycemia.Methods Autologous blood injection method was used to establish the model of intracerebral hemorrhage.80 SD rats were randomly divided into sham operation group（n=5）,cerebral hemorrhage group（n=25）,hyperglycemia of 2g/kg after intracerebral hemorrhage group A（n=25）,and hyperglycemia of 4g/kg after intracerebral hemorrhage group B（n=25）.Contents of LA,IL-1β and TNF-α around the hematoma of each group were measured on 1d,3d,7d,10d and 14d.Results Compared with sham-operated group,the contents of LA,IL-1β and TNF-α around hematoma of other three intracerebral hemorrhage groups increased significantly（P0.05）.Compared with intracerebral hemorrhage group,the contents of LA,IL-1β and TNF-α around hematoma of hyperglycemia group A and B increased significantly（P0.05）,and group B showed more prominent change.Conclusion Hyperglycemia after cerebral hemorrhage can ead to energy metabolism disorders and LA accumulation,which probably aggravates the brain damage by enhancing inflammation.