CAJ | 학술논문

目的观察针刺联合微创血肿抽吸术对家兔急性期脑出血灶周围脑组织损伤的影响.方法共选取健康新西兰大白兔65只,将其随机分为假手术组、脑出血组、血肿抽吸组及血肿抽吸+针刺组.将脑出血组、血肿抽吸组及血肿抽吸+针刺组制成脑出血模型,制模后血肿抽吸组给予血肿抽吸治疗,血肿抽吸+针刺组则给予针刺及血肿抽吸联合治疗.分别于制模后6 h、24 h、3 d及7 d时称量不同组别脑组织干湿重并计算脑含水量,采用免疫组化法检测各组家兔血肿周围脑组织基质金属蛋白酶-9(MMP-9)表达,采用明胶酶谱技术检测各组家兔血肿周围脑组织MMP-9活性.结果脑出血组、血肿抽吸组及针刺+血肿抽吸组脑含水量均较假手术组显著增高,随着时间进展,血肿抽吸组及针刺+血肿抽吸组脑含水量较脑出血组均有明显降低(P＜0.05或0.01),其中以制模后第3天时针刺+血肿抽吸组的下降幅度尤为显著(P＜0.01);免疫组化及明胶酶谱检测结果显示,各组家兔MMP-9阳性细胞表达及活性均随时间进展呈下降趋势,其中以制模后第3天时针刺+血肿抽吸组的下降幅度最为显著(P＜0.01).结论针刺联合血肿抽吸术可显著减轻家兔急性期脑出血灶周围脑组织损伤,其治疗机制可能与抑制MMP-9表达有关.
목적 관찰침자연합미창혈종추흡술대가토급성기뇌출혈조주위뇌조직손상적영향.방법 공선취건강신서란대백토65지,장기수궤분위가수술조、뇌출혈조、혈종추흡조급혈종추흡+침자조.장뇌출혈조、혈종추흡조급혈종추흡+침자조제성뇌출혈모형,제모후혈종추흡조급여혈종추흡치료,혈종추흡+침자조칙급여침자급혈종추흡연합치료.분별우제모후6 h、24 h、3 d급7 d시칭량불동조별뇌조직간습중병계산뇌함수량,채용면역조화법검측각조가토혈종주위뇌조직기질금속단백매-9(MMP-9)표체,채용명효매보기술검측각조가토혈종주위뇌조직MMP-9활성.결과 뇌출혈조、혈종추흡조급침자+혈종추흡조뇌함수량균교가수술조현저증고,수착시간진전,혈종추흡조급침자+혈종추흡조뇌함수량교뇌출혈조균유명현강저(P＜0.05혹0.01),기중이제모후제3천시침자+혈종추흡조적하강폭도우위현저(P＜0.01);면역조화급명효매보검측결과현시,각조가토MMP-9양성세포표체급활성균수시간진전정하강추세,기중이제모후제3천시침자+혈종추흡조적하강폭도최위현저(P＜0.01).결론 침자연합혈종추흡술가현저감경가토급성기뇌출혈조주위뇌조직손상,기치료궤제가능여억제MMP-9표체유관.
Objective To investigate the effect of acupuncture combined with minimally invasive hematoma aspiration on a rabbit model of brain injury in the acute stage of intracerebral hemorrhage (ICH). Methods A total of 65 healthy New Zealand white rabbits were randomly divided into a sham operation (SO) group, an ICH group,a hematoma aspiration (HA) group, and an acupuncture and hematoma aspiration (AHA) group. Models of ICH were established in the latter three groups. The HA group was treated with minimally invasive hematoma aspiration and the AHA group was treated with both acupuncture and minimally invasive hematoma aspiration. At 6 hours and 1, 3 and 7 days after the ICH models were established, brain water content (BWC) was measured, and the expression of matrix metalloproteinase-9 ( MMP-9 ) in the rabbits' brains was detected by immunohistochemistry. MMP-9activity was detected by gelatin zymography. Results The BWCs of the ICH group, HA group and AHA group rabbits were significantly higher than those of the SO group. The BWCs of the HA group and AHA group animals descended significantly more than those in the ICH group as time went on, especially on the 3rd day in the AHA group. Immunohistochemistry and gelatin zymography showed that the expression and activity of MMP-9 in these test groups decreased with time, especially on the 3rd day in the AHA group. Conclusions Acupuncture combined with hematoma aspiration can reduce injury in the acute stage of ICH, and inhibition of the expression of MMP-9 may be the mechanism.