CAJ | 학술논문

目的探讨微创血肿抽吸治疗对锥体束修复和神经功能改善的作用.方法雄性SD大鼠48只按随机数字表法分为正常对照组(n=8)、假手术组(n=8)、脑出血自然恢复组和脑出血后6、12、24 h微创血肿抽吸组(n=8),后4组大鼠注射Ⅳ型胶原酶-肝素混合液建立基底节脑出血模型,假手术组注射等量生理盐水.造模后6、12、24 h行微创血肿抽吸治疗后3组大鼠.2周后按照"楼梯测试"前肢功能的测试方法对各组大鼠进行前肢功能评分,免疫组化染色观察内囊后肢锥体束神经丝蛋白(NF)和神经生长相关货白(GAP-43)的表达.结果各组大鼠造模前左前肢抓取能力比较差异无统计学意义(P＞0.05),造模后14 d微创血肿抽吸组前肢抓取功能均高于自然恢复组,其中6 h抽吸组高于12、24 h抽吸组,差异有统计学意义(P＜0.05);免疫组化染色结果显示微创血肿抽吸组NF染色阳性纤维、GAP-43的表达明显多于脑出血自然恢复组,6 h抽吸组NF染色阳性纤维多于12、24 h抽吸组,差异有统计学意义(P＜0.05),而6 h和12 h抽吸组GAP-43的表达高于24 h抽吸组,差异有统计学意义(p＜0.05).结论脑出血后24 h内,尤其是6 h内予以微创血肿抽吸治疗能减轻内囊后肢锥体束的损伤,利于锥体束的修复,改善神经功能.
목적 탐토미창혈종추흡치료대추체속수복화신경공능개선적작용.방법 웅성SD대서48지안수궤수자표법분위정상대조조(n=8)、가수술조(n=8)、뇌출혈자연회복조화뇌출혈후6、12、24 h미창혈종추흡조(n=8),후4조대서주사Ⅳ형효원매-간소혼합액건립기저절뇌출혈모형,가수술조주사등량생리염수.조모후6、12、24 h행미창혈종추흡치료후3조대서.2주후안조"루제측시"전지공능적측시방법대각조대서진행전지공능평분,면역조화염색관찰내낭후지추체속신경사단백(NF)화신경생장상관화백(GAP-43)적표체.결과 각조대서조모전좌전지조취능력비교차이무통계학의의(P＞0.05),조모후14 d미창혈종추흡조전지조취공능균고우자연회복조,기중6 h추흡조고우12、24 h추흡조,차이유통계학의의(P＜0.05);면역조화염색결과현시미창혈종추흡조NF염색양성섬유、GAP-43적표체명현다우뇌출혈자연회복조,6 h추흡조NF염색양성섬유다우12、24 h추흡조,차이유통계학의의(P＜0.05),이6 h화12 h추흡조GAP-43적표체고우24 h추흡조,차이유통계학의의(p＜0.05).결론 뇌출혈후24 h내,우기시6 h내여이미창혈종추흡치료능감경내낭후지추체속적손상,리우추체속적수복,개선신경공능.
Objective To explore the effects of the minimally invasive hematoma aspiration on the repair of the pyramidal tract and improvement of neurological function. Methods Forty-eight SD male rats were equally randomized into normal control group, sham-operated group, cerebral hemorrhage group (model), model + minimally invasive hematoma aspiration at the 6th, 12th, and 24th h groups (n=8).Intracerebral hemorrhage in the later 4 groups was induced by injection of type IV collagenase + heparin into the caudate nucleus of rats, and the same amount of normal saline was injected into the sham-operated group. And then, the hematoma was lysed by injection of urokinase into the hematoma center 6, 12 and 24 h after intracerebral hemorrhage in the later 3 groups, respectively. Animals were sacrificed after behavioral function evaluation 14 d after collagenase injection. Immunohistochemistry was performed to observe the expressions of neurofilament (NF) and growth associated protein-43(GAP-43) in the posterior limb of internal capsule. Results The snatch ability of left forelimb among all the groups showed no significant differences before the success of model making (P＞0.05). The snatch ability of left forelimb in each hematoma aspiration group was much higher than that in the model group on the 14th d of collagenase injection (P＜0.05). Within the hematoma aspiration groups, the snatch ability in the group performed hematoma aspiration at the 6th h was higher than those group at the 12th and 24th h (P＜0.05). The number of NF positive fibers and the expression of GAP-43 in the 3hematoma aspiration groups were much larger or higher than those in the model group (P＜0.05); the number of NF positive fibers in the group performed hematoma aspiration at the 6th h was larger than that in those group at the 12th and 24th h (P ＜0.05); The expression of GAP-43 in the group performed hematoma aspiration at the 6th and 12th h was higher than that in the group at the 24th h (P＜0.05).Conclusion The minimally invasive hematoma aspiration performed within 24 h of intracerebral hemorrhage, especially those within 6 h, would reduce the pyramidal tract's injury, promote the repair of pyramidal tract and improve the neurological function.