高血压脑出血患者β淀粉样蛋白的表达及其与血肿周围组织细胞凋亡的关系

The expression of amyloidβin patients with hypertensive intracerebral hemorrhage and its relationship with apoptosis of perihematomal tissue

目的探讨高血压脑出血(HICH)患者β淀粉样蛋白(Aβ)的表达及其与血肿周围组织细胞凋亡的关系。方法收集2010年3月到2016年3月该院收治的42例拟行颅脑血肿清除术的HICH患者。根据发病到接受手术的时间,将42例患者分为A组(<6h,20例)、B组(6～<12h,9例)、C组(12～<24h,6例)、D组(24～48h,4例)和E组(>48h,3例)。以血肿周围组织为研究标本,以远离血肿脑组织为对照标本。分别予以HE染色,DNA断裂的原位末端标记法(TUNEL法)检测各组血肿周围组织凋亡细胞。采用酶联免疫吸附试验和免疫组化法检测各组血清和血肿周围组织Aβ的表达。结果与对照标本比较,A、B、C、D、E组血肿周围组织凋亡细胞个数均增多(P<0.05);与A组比较,B、C、D、E组血肿周围组织凋亡细胞个数均增多(P<0.05),且随着HICH发病时间到接受手术时间的延长,血肿周围组织凋亡细胞个数呈先增多后减少,以24～48h血肿周围组织凋亡细胞个数最多;与A组比较,B、C、D、E组血清Aβ的表达均升高(P<0.05),血肿周围组织Aβ阳性细胞个数均增多(P<0.05),且随着HICH发病时间到接受手术时间的延长,血清和血肿周围组织Aβ的表达呈先升高后下降,以12～<24h血清和血肿周围组织Aβ的表达最高;与对照标本比较,A、B、C、D、E组血肿周围组织Aβ阳性细胞个数均增多(P<0.05);Pearson相关分析,血清Aβ含量和血肿周围组织凋亡细胞个数之间呈正相关(r=0.482,P=0.001),血肿周围组织Aβ阳性细胞个数和血肿周围组织凋亡细胞个数之间呈正相关(r=0.940,P<0.05)。结论 HICH患者血肿周围组织中存在着大量凋亡细胞,HICH血清和血肿周围组织存在Aβ高表达。血清Aβ含量、血肿周围组织Aβ阳性细胞数目与血肿周围组织凋亡细胞数目呈正相关,提示Aβ可能参与HICH血肿周围组织细胞凋亡。

Objective To explore the expression of amyloid β （Aβ） in patients with hypertensive intracere bral hemorrhage （HICH） and its relationship with apoptosis of perihematomal tissue. Methods 42 HICH pa tients who underwent brain hematoma removal in the hospital from June 2010 to March 2016 were enrolled in the study. According to the time of onset to surgery,42 HICH patients were divided into A group （〈6 h,20 cases）,Bgroup （6 〈12 h,9 cases）,Cgroup （12 〈24 h,6 cases） ,D group （24 48 h,4 cases） andEgroup （〉48 h,3 cases）. The perihematomal tissue was taken as the research sample and the brain tissue away from the perihematomal was taken as the control sample. HE staining and TUNEL method were used to detect ap optotic cells in the tissues around hematoma. The expression of serum Aβ and perihematomal tissue Aβ were detected by ELISA and immuno histochemistry respectively. Results The number of apoptosis of perihematoreal tissue in the A, B,C,D,E groups were all increased compared with the control sample （P〈0.05）. The number of apoptosis of perihematomal tissue in the B,C,D,E groups were all increased compared with the A group （P〈0. 05） ,which increased first and then decreased with the time of HICH onset to surgery,reaching the highest at 24 48 h. Compared with the A group , the expression of serum Aβ in the B,C,D,E groups were all increased （P〈0. 05） ,and the number of A〈 positive cells in perihematomal tissue were all increased （P〈 0.05） ,which first increased and then decreased with the time of HICH onset to surgery,reaching the highest at 12 〈24 h. Compared with the control sample,the number of A〈 positive cells in perihematomal tissue in the A,B,C,D,E groups were all increased （P〈0.05）. Pearson correlation showed that the level of serum Aβ was positively correlated with the number of apoptosis of perihematomal tissue （r=0. 482,P=0. 001） ,and the number of Aβ positive cells in perihematomal tissue was positively correlated with the number of apoptosis of perihematomal tissue （r=0.940,P〈0.05）.Conclusion A large number of apoptotic cells were found in the tissues around the hematoma in patients with HICH,and high expression of Aβ was found in the serum and tissues around the hematoma in patients with HICH. Serum A〈 level and the number of Aβ positive cells in the tissues around the hematoma were positively correlated with the number of apoptotic cells in the tissues a round the hematoma,suggesting that Aβ may participate in the apoptosis of the tissues around the hematoma in HICH.