颅内静脉窦血栓不同时期血栓性质动态变化

Study on the dynamic changes of thrombus after intracracnical venous sinus thrombosis

目的研究上矢状窦血栓形成后不同时期血栓的病理性质。方法用改良法建立SD大鼠上矢状窦血栓模型,将大鼠随机分为4组,每组20只。模型成功后于1、2、3、4周行核磁共振扫描观察上矢状窦闭塞和血流再通情况,并处死大鼠取上矢状窦和血栓标本,进行光镜病理学研究和透射电镜观察各组内皮细胞超微结构改变。结果核磁共振检查自发再通率8.75%。随着血栓形成时间延长,血栓逐渐出现机化和钙化,2周和1周组的血栓机化率无统计学意义(X2=0.1441,P=0.230),2周和3周组机化率有统计学差异(X2=16.942,P<0.01),3周和4周组机化率无统计学差异(X2=0.784,P=0.376);2周和3周组钙化率没有统计学差异(X2=2.053,P=0.487),3周和4周组比较差异有统计学意义(X2=6.144,P=0.013)。透射电镜观察3周、4周组可见血栓机化和内皮细胞损伤。结论大鼠上矢状窦血栓形成后血栓可发生机化和钙化,机化和钙化率随时间延长而增高。

Objective To investigate pathobiology changes in different time after thrombosis of intracranial venous sinus in rats. Methods Modified reversible intracranial cerebral venous sinus thrombosis models were made in total 80 male Sprague-Dawley rats. The model rats were randomly divided into four groups and were killed at 1,2, 3 and 4 weeks. The light and electron microscope were used to detect the rat superior sagittal sinus （SSS） pathology and endothelial cell changes. The MRI scan was performed to confirm the success of models and investigate the blood flow of the SSS. Results MRI showed the rate of recanalization was 8.75%. Thrombus organization and calcification were appeared gradually. The rates of organization and calcification were 90% and 45%, respectively. The rate of thrombus organization was not signifi- cantly different between 2 week group and 1 week group （ Z2 = 0. 1441 ,P = 0. 230）. The rate of thrombus organization in 3 week group was significant higher than that in 2week group （.Z2 = 16. 942, P = 0. 000）. The rate of thrombus organization was no significantly different between 4 week group and 3 week group （ Z2 = O. 784, P = 0. 376）. The rate of thrombus calci- fication in 4 week group was significant higher than that in 3 week group（ Z2 =6. 144 ,P =0. 013）. But there was no signifi- cant difference in the rate of thrombus calcification between 3 week group and 2 week group（ Z2 = 2. 053, P = 0. 487 ）. E- lectron microscope revealed the thrombus organization and endothelial cell injury in 3 week group and 4 week group. Con- clusions Superior sagittal sinus thrombosis can induce the organization and calcification in rats. The rates of the organiza- tion and calcification are increased in a time-dependent manner.