中国危重病急救医学
中國危重病急救醫學
중국위중병급구의학
CHINESE CRITICAL CARE MEDICINE
2008年
12期
740-742,前插9
,共4页
宋锦宁%梁琦%张明%刘守勋
宋錦寧%樑琦%張明%劉守勛
송금저%량기%장명%류수훈
蛛网膜下腔出血%脑组织%内皮素受体A
蛛網膜下腔齣血%腦組織%內皮素受體A
주망막하강출혈%뇌조직%내피소수체A
subarachnoid hemorrhage%brain tissue%endothelin receptor A
目的 探讨蛛网膜下腔出血(SAH)后脑组织内皮素受体A(ETRA)的表达与延迟性神经功能障碍(DND)之间的关系.方法 将31只日本大耳白兔随机分组:SAH组15只,盐水对照组10只,穿刺对照组与正常对照组各3只,SAH组和盐水对照组再均分为制模后1 h、3 d、5 d、7 d、10 d共5个亚组,采用枕大池二次注血法制备兔SAH模型.按各时间点将兔进行灌注,处死后取其被血液浸泡的基底动脉中段脑干组织制成切片,进行苏木素一伊红(HE)染色及ETRA免疫组化染色;光镜下观察延髓组织病理学变化,采用阳性细胞计数法对ETRA进行半定量分析.结果 穿刺对照组、正常对照组兔脑组织中神经元细胞和胶质细胞胞质内均有少量ETRA表达[(10.6±3.9)个/视野,(10.0±2.8)个/视野];盐水对照组内有个别细胞表达ETRA,对各亚组间阳性细胞计数进行方差分析,结果显示差异无统计学意义[最低(12.3±2.1)个/视野,最高(13.3±2.6)个/视野,P>0.05];SAH组制模后1 h ETRA表达的阳性细胞计数有轻微升高C(20.1>3.5)个/视野],3 d表达最强烈[(48.8±6.7)个/视野],5、7、10 d呈缓慢下降的趋势[分别为(23.1±2.9)、(22.5±4.2)、(19.1±2.8)个/视野],方差分析结果显示差异有统计学意义(P<0.05),且制模后各时间点ETRA阳性细胞数明显高于盐水对照组(P均<0.05).结论 SAH后兔脑组织ETRA呈高度表达;ETRA可能在DND的发病机制中起到重要的作用.
目的 探討蛛網膜下腔齣血(SAH)後腦組織內皮素受體A(ETRA)的錶達與延遲性神經功能障礙(DND)之間的關繫.方法 將31隻日本大耳白兔隨機分組:SAH組15隻,鹽水對照組10隻,穿刺對照組與正常對照組各3隻,SAH組和鹽水對照組再均分為製模後1 h、3 d、5 d、7 d、10 d共5箇亞組,採用枕大池二次註血法製備兔SAH模型.按各時間點將兔進行灌註,處死後取其被血液浸泡的基底動脈中段腦榦組織製成切片,進行囌木素一伊紅(HE)染色及ETRA免疫組化染色;光鏡下觀察延髓組織病理學變化,採用暘性細胞計數法對ETRA進行半定量分析.結果 穿刺對照組、正常對照組兔腦組織中神經元細胞和膠質細胞胞質內均有少量ETRA錶達[(10.6±3.9)箇/視野,(10.0±2.8)箇/視野];鹽水對照組內有箇彆細胞錶達ETRA,對各亞組間暘性細胞計數進行方差分析,結果顯示差異無統計學意義[最低(12.3±2.1)箇/視野,最高(13.3±2.6)箇/視野,P>0.05];SAH組製模後1 h ETRA錶達的暘性細胞計數有輕微升高C(20.1>3.5)箇/視野],3 d錶達最彊烈[(48.8±6.7)箇/視野],5、7、10 d呈緩慢下降的趨勢[分彆為(23.1±2.9)、(22.5±4.2)、(19.1±2.8)箇/視野],方差分析結果顯示差異有統計學意義(P<0.05),且製模後各時間點ETRA暘性細胞數明顯高于鹽水對照組(P均<0.05).結論 SAH後兔腦組織ETRA呈高度錶達;ETRA可能在DND的髮病機製中起到重要的作用.
목적 탐토주망막하강출혈(SAH)후뇌조직내피소수체A(ETRA)적표체여연지성신경공능장애(DND)지간적관계.방법 장31지일본대이백토수궤분조:SAH조15지,염수대조조10지,천자대조조여정상대조조각3지,SAH조화염수대조조재균분위제모후1 h、3 d、5 d、7 d、10 d공5개아조,채용침대지이차주혈법제비토SAH모형.안각시간점장토진행관주,처사후취기피혈액침포적기저동맥중단뇌간조직제성절편,진행소목소일이홍(HE)염색급ETRA면역조화염색;광경하관찰연수조직병이학변화,채용양성세포계수법대ETRA진행반정량분석.결과 천자대조조、정상대조조토뇌조직중신경원세포화효질세포포질내균유소량ETRA표체[(10.6±3.9)개/시야,(10.0±2.8)개/시야];염수대조조내유개별세포표체ETRA,대각아조간양성세포계수진행방차분석,결과현시차이무통계학의의[최저(12.3±2.1)개/시야,최고(13.3±2.6)개/시야,P>0.05];SAH조제모후1 h ETRA표체적양성세포계수유경미승고C(20.1>3.5)개/시야],3 d표체최강렬[(48.8±6.7)개/시야],5、7、10 d정완만하강적추세[분별위(23.1±2.9)、(22.5±4.2)、(19.1±2.8)개/시야],방차분석결과현시차이유통계학의의(P<0.05),차제모후각시간점ETRA양성세포수명현고우염수대조조(P균<0.05).결론 SAH후토뇌조직ETRA정고도표체;ETRA가능재DND적발병궤제중기도중요적작용.
Objective To discuss the relationship between the expression of endothelin receptor A (ETRA) in brain tissue and delayed neurological deficit (DND) after subarachnoid hemorrhage (SAH). Methods Thirty-one Japanese rabbits were divided into SAH group (n=15), saline group (n= 10), puncture group (n=3), normal control group (n= 3) randomly, and they subdivided into 1 hour, 3 days, 5 days, 7 days, 10 days subgroups in both SAH group and saline group. The SAH model was successfully reproduced by intracisternal injection of autologous arterial blood twice. When the animals were sacrificed by perfusion, brain stems were harvested and prepared for immunohistochemical staining and hematoxylin and eosin (HE) staining. The pathological changes in the brain tissue were observed with light microscope. Then positive-cell counting was used to semi-quantitative analysis. Results The expression of ETRA was not detected nearly in neurons or gliocyte either in puncture group (10. 6± 3. 9) or in normal group (10. 0± 2.8), while it was detected in some cells in saline group. But no significant difference was showed among the subgroups in saline group (12.3±2.1 lowest vs. 13.3±2. 6 highest, P>0. 05) by variance analysis. The expression of ETRA in SAH group was slightly stronger after 1 hour (20. 1 ± 3. 5), peaked at 3 days (48. 8±6. 7), and became weak gradually after 5 days. The ETRA positive cells at 5 days, 7 days, and 10 days were 23. 1 ± 2.9, 22.5 ± 4.2 and 19.1 ± 2.8 respectively. There were significant differences among the values at different time points (P<0.05) in SAH group, and the positive cells of ETRA were obviously increased in number in SAH group at all time points compared with saline group (all P<0. 05). Conclusion ETRA is expresseddistinctly in the brain tissue, and it may play an important role in DND pathogenesis.
