CAJ | 학술논문

目的探讨蛛网膜下腔出血(SAH)大鼠脑实质内大分子物质经淋巴引流的变化.方法将健康成年雄性Wistar大鼠分为生理盐水组、伊文思蓝标记白蛋白(EBA)组、SAH+EBA组.采用枕大池两次注入自体动脉血法建立SAH模型,应用改良的脑实质微量注射技术将EBA注入大鼠左侧尾壳核,生理盐水组用生理盐水代替EBA.于注射后0.5、1、2、3、5 d处死动物,观察并比较各组不同时间点EBA在脑内、颈总动脉壁、颈部淋巴结等部位的分布.结果 EBA组于注射后1 d荧光信号首先出现在左侧脑实质、侧脑室及其血管周围,并逐步到达对侧;双侧颈总动脉外膜有密集的荧光信号,颈部淋巴结可见荧光信号.2 d后脑内荧光信号明显减弱,嗅球内荧光信号逐渐增强,腹主动脉旁淋巴结内有点状荧光信号.各淋巴结内荧光均于3 d时最强.SAH后脑内EBA引流至嗅球、颈部淋巴结和腹主动脉旁淋巴结的量减少且速度减慢.于0.5、1、2、3、5 d,EBA组颈深淋巴结EBA荧光密度分别为14.5±3.2、27.5±7.4、60.3±12.3、138.0±12.0和108.1±13.4,SAH+EBA组分别为8.9±2.0、11.9±2.5、17.4±3.7、26.7±4.5和59.0±8.1,后组各时间点密度均低于前组(F=13.17、24.04、66.81、302.77、59.36,P＜0.01);2、3、5 d,EBA组腹主动脉旁淋巴结EBA荧光密度分别为26.3±5.9、47.5±9.6和41.0±9.3,SAH+EBA组分别为11.0±1.5、12.5±2.8、23.6±3.2,后组各时间点均低于前组(F=38.17、72.52、19.01,P＜0.01).结论 SAH可导致脑内大分子物质经淋巴系统引流的功能障碍.
목적 탐토주망막하강출혈(SAH)대서뇌실질내대분자물질경림파인류적변화.방법 장건강성년웅성Wistar대서분위생리염수조、이문사람표기백단백(EBA)조、SAH+EBA조.채용침대지량차주입자체동맥혈법건립SAH모형,응용개량적뇌실질미량주사기술장EBA주입대서좌측미각핵,생리염수조용생리염수대체EBA.우주사후0.5、1、2、3、5 d처사동물,관찰병비교각조불동시간점EBA재뇌내、경총동맥벽、경부림파결등부위적분포.결과 EBA조우주사후1 d형광신호수선출현재좌측뇌실질、측뇌실급기혈관주위,병축보도체대측;쌍측경총동맥외막유밀집적형광신호,경부림파결가견형광신호.2 d후뇌내형광신호명현감약,후구내형광신호축점증강,복주동맥방림파결내유점상형광신호.각림파결내형광균우3 d시최강.SAH후뇌내EBA인류지후구、경부림파결화복주동맥방림파결적량감소차속도감만.우0.5、1、2、3、5 d,EBA조경심림파결EBA형광밀도분별위14.5±3.2、27.5±7.4、60.3±12.3、138.0±12.0화108.1±13.4,SAH+EBA조분별위8.9±2.0、11.9±2.5、17.4±3.7、26.7±4.5화59.0±8.1,후조각시간점밀도균저우전조(F=13.17、24.04、66.81、302.77、59.36,P＜0.01);2、3、5 d,EBA조복주동맥방림파결EBA형광밀도분별위26.3±5.9、47.5±9.6화41.0±9.3,SAH+EBA조분별위11.0±1.5、12.5±2.8、23.6±3.2,후조각시간점균저우전조(F=38.17、72.52、19.01,P＜0.01).결론 SAH가도치뇌내대분자물질경림파계통인류적공능장애.
Objective To investigate the pathway of lymphatic drainage of proteins from cerebral parenchyma in subarachnoid hemorrhage rat models. Methods Healthy adult male Wistar rats were divided into Saline group, Evans blue-labeled albumin (EBA) group, and SAH + EBA group. SAH models were produced by double injection of autologous arterial blood into cisterna magna. Using a modified microinjection method, EBA was injected into left candate-putamen of the EBA group and EBA + SAH group rats. In Saline control group, saline was injected. After injection, at 12 hours, 1 day, 2 days, 3 days and 5 days, the animals were sacrificed and the fluorescence signals of EBA were imagined and analyzed along the possible lymphatic drainage pathway, e.g. the brain tissue, the wall of common carotid artery, and cervical lymphatic nodes. Results One day after injection, in EBA group, the fluorescence of EBA initially appeared on the left of the brain, the wall of common carotid artery, left lateral cerebral ventricle, and the perivascular spaces of cerebral vessels. The fluorescence signals gradually expanded to the opposite side.Large amount of fluorescence granules accumulated in the outer layer of common carotid artery. Fluorescence was also found in cervical lymphatic nodes. Two days after injection in this group, the density of fluorescencein the brain became weaker while the density of fluorescence in rhinencephalon became stronger. The fluorescence of EBA was found in lymphatic nodes adjacent to abdominal aorta. In SAH + EBA group,reduced amount and velocity of the drainage of EBA from left caudate-putamen to rhinencephalon, cervical lymphatic nodes, and lymphatic nodes adjacent to abdominal aorta were observed. From 12 hours to 5 days after injection, fluorescence intensity of EBA in deep cervical lymphatic nodes in SAH + EBA group(8.9 ±2. 0, 11.9 ± 2. 5, 17.4 ± 3.7, 26.7 ± 4. 5 and 59.0 ± 8. 1 ) were lower than those in EBA group ( 14. 5 ±3.2, 27.5 ±7.4, 60.3 ±12.3, 138.0±12.0 and 108. 1 ±13.4, F=13. 17, 24.04, 66.81, 302.77 and 59.36, P ＜ 0. 01 ). From 2 to 5 days, fluorescence intensity of EBA in lymphatic nodes adjacent to abdominal aorta was also lower in SAH + EBA group( 11.0 ± 1.5, 12. 5 ±2. 8, 23.6 ±3. 2) than those in EBA group(26. 3 ±5.9, 47.5 ±9.6, 41.0 ±9.3; F =38. 17, 72.52, 19.01, P ＜0.01). Conclusion SAH can result in reduced drainage of macromolecular substances, e.g. protein, from the brain via lymphatic pathway.