颅脑损伤早期水通道蛋白4表达的临床研究

Clinical study on expression of AQP 4 in the early stagetraumatic brain injury

目的：研究颅脑损伤24h内水通道蛋白4（AQP4）的表达变化与颅脑损伤的伤情程度和伤后时间的关系。方法：39例颅脑损伤24h内患者,按照GCS评分分为3组：轻中型颅脑损伤（GCS 915分）11例,重型颅脑损伤（GCS 68分）13例,特重型颅脑损伤（GCS 35分）15例,以上3组再根据伤后距手术时间不同分为≤6 h6、12 h和〉12 h各3组;手术中取损伤区脑组织标本,用免疫组化方法检测AQP4的表达。结果：伤情程度越重,AQP4的表达量越大;随着伤后时间的延长,AQP4表达量逐渐增多。各组进行析因分析,伤情程度各组差异有统计学意义（F=3.686,P〈0.05）;不同时间段各组差异也有统计学意义（F=3.794,P〈0.05）。结论：颅脑损伤后24h内,伤情程度越重,损伤时间越长,AQP4表达量越多。

Objective： To investigate the changes in AQP4 expression after traumatic brain injury（TBI）,and its correlation with the severity and progress of the injury.Methods： A total of 39 patients with TBI occurred within 24 hours were assigned into three groups based on the Glasgow Coma Scale（GCS） scores： mild to moderate（GCS 9-15） group（11 cases）,severe（GCS 6-8） group（13 cases）and critical severe（GCS 3-5） group（15 cases）.Then each group was divided into three subgroups according to post-injury time which was ≤6h,6-12h,and〉12h.The morphological changes of the brain specimens were observed with electron microscope.The expressions of AQP4 were detected with immunohistochemistry.Results： The expression of AQP4 in the cytoplasm and cytomembrane increased with the severity TBI and post-injury time.AQP4 expression was significantly different among the three groups（F=3.686,P〈0.05）.significant difference was also observed among subgroups（F=3.794,P〈0.05）.Conclusions： The expression of AQP4 increased with severity and post-injury time after TBI during the first 24 hours.