脑出血灶周MMP-9的表达与脑水肿的实验研究

Experimental study on the expression of cerebral hemorrhage perifocal MMP-9 and brain edema

目的明确脑出血后灶周脑组织不同时间点MMP-9蛋白的表达规律,在脑水肿的发生、发展过程中可能作用,相关性及临床意义。方法本研究以不同时间点高血压脑出血患者开颅手术中取的脑出血灶周组织为实验组标本,按脑出血发病时间分为6 h、6~24 h、24 h^3 d、>3 d组。以手术入路时少量破坏的脑组织做为对照组标本,通过干湿比重法测脑组织含水量,同时应用HE染色,RT-PCR方法观察各时间点各组脑出血灶周脑组织MMP-9的表达变化。结果 (1)脑出血灶周脑组织含水量的变化:脑出血后灶周脑水肿程度随出血时间的延长逐渐增加,在出血6 h内含水量即开始增加,24 h后较6 h明显增高,3 d左右达到峰值,之后减轻(P<0.05);(2)在人脑出血血肿灶周中MMP-9圴有表达,出血组与对照组相比均有显著性意义(P<0.05),且出血各组之间比较均有差异(P<0.05)。出血6 h后免疫阳性细胞数开始增加,3 d组阳性细胞数最多,之后逐渐下降。MMP-9与脑水肿成正相关。结论 (1)脑出血灶周MMP-9的表达与脑水肿密切相关;(2)在高血压脑出血后脑水肿中MMP-9的异常表达起重要作用,促进脑水肿的发生,为脑出血的治疗提供新的靶点。

Objective To clear the cerebral hemorrhage perifocal brain tissue at different time points of MMP-9 protein expression pattern the possible role of the occurrence and development of cerebral edema correlation and its clinical significance. Methods The cerebral hemorrhage foci were taken during the craniotomy operation for patients with cerebral hemorrhage at different time points. The patients were divided into 〈6 h,24 h ~ 3 d,6 ~ 24 h and 〉3 d groups according to the time of onset. To operative cranial path away from the hematoma at a little damage of brain tissue do as the samples in the control group by dry wet weighing method in measuring the brain water content,and immunohistochemical staining and RT-PCR methods observe changes of brain tissue around the MMP-9 expression in each group at different time points lesions. Results（1） The water content of brain tissue changeds,cerebral hemorrhage cerebral edema with bleeding time increased,in 6 h containing water hemorrhage increased significantly,after 24 h significantly increased,peaked in about three days,then reduced（ P 〈0. 05）.（2） In the human brain hemorrhage perifocal MMP-9 shall have expression expressed,as compared with the control group,hemorrhage group were significant（ P 〈0. 05） compared to and bleeding between groups comparison showed a significant difference（ P〈 0. 05）. The number of immune positive cells increased after bleeding 6 h,and the cell numbers of 24 h ~ 3 d cells was the most,then decreased gradually. MMP-9 was positively related to cerebral edema. Conclusion （1） The expression of MMP-9 in the human brain was significantly higher which was closely related to cerebral edema.（2） Abnormal expression of MMP-9 plays an important role in cerebral edema after hypertensive intracerebral hemorrhage and promotes the occurrence of cerebral edema and provides a new target for the treatment of cerebral hemorrhage.