大鼠淋巴滞留性脑水肿的病理学研究

Lymphostatic cerebral edema in rat:A pathological study

目的 :探讨淋巴滞留性脑水肿的发病过程及病理特点。方法 :采用阻断大鼠脑淋巴引流的方法 ,建立淋巴滞留性脑水肿模型 ,观察其行为变化 ,并从术后不同时间取脑标本 ,进行肉眼观察、HE染色及TUNEL染色光镜观察、透射及扫描电镜观察。结果 :自术后第 2天动物出现明显行为改变 ;脑膜及脑组织肿胀、充血 ,小血管壁外膜及Virchow Robin间隙增宽 ,内含大量水肿液 ,毛细血管基底膜肥厚 ,神经元固缩、凋亡或肿胀、坏死 ,胶质细胞增生 ,硬脑膜表面凹凸不平 ,水肿明显。上述变化以术后 5天最显著。结论 :脑淋巴引流阻断后 ,可以导致淋巴滞留性脑水肿 ,其发病机制与 3种传统类型的脑水肿不同 。

Purpose To investigate the pathogenesis and pathology of lymphostatic cerebral edema. Method The model of lymphostatic cerebral edema was established by occluding lymphatic drainage of the brains in rats. After the blocking behavioral alterations were observed in the animals, and the tissues of their brains were studied in 1 d, 2 d, 3 d, 5 d and 7 d after operation, at the gross, light microscopic(HE stain and TUNEL stain) and electron microscopic levels(transmission and scanning). Results From the second day of the operation, there had been some behavioral alterations of the rats. The meninges tightened, and the brain swollen overtly. The adventitia of the brain arteries and the perivascular Virchow Robin space dilated irregularly. There was intracellular edema of the astrocytes and the nerve cells. In some neurons both the nucleus and cytoplasm condensed, chromatin gathered near the nuclear membrane. Some other neuron appeared to be degeneration and necrosis. This alteration could be seen in the cerebral cortex of parietal lobus and hippocampal CA1 field mainly. The changes above were most noticeable on 5th day after the blocking. Conclusions The blockage of the drainage of cerebral lymphatic can lead to lymphostatic cerebral edema. The mechanism of lymphostatic cerebral edema is different from that in the other 3 kinds of classical cerebral edema. It belongs to another kind of independent brain edema.