【摘要】 目的：观察水蛭对脑出血的治疗作用，并探讨其作用机制。方法：５６只ＳＤ大鼠随机分为６组：水蛭大、中、小剂量（分别用相当于生药９００ｍｇ／ｋｇ、４５０ｍｇ／ｋｇ和２２５ｍｇ／ｋｇ）治疗组（分别为１０只、８只和１０只动物），实验对照７日、１４日及假手术组（分别为１４只、６只和８只）。大鼠均于术后７日（实验对照１４日组为１４日）处死；观察神经功能障碍，脑组织含水量，脑组织中超氧化物歧化酶（ＳＯＤ）、谷胱甘肽过氧化物酶（ＧＳＨＰｘ）活力及丙二醛（ＭＤＡ）含量，血中三碘甲状腺原氨酸（Ｔ３）、甲状腺素（Ｔ４）、生长素（ＧＨ）、泌乳素（ＰＲＬ）和皮质醇（ＣＳ）浓度及脑组织病理学变化（含电镜及ＨＥ染色、ＶＧ染色、银染与ＧＦＡＰ免疫组化染色的光镜观察）。结果：水蛭治疗组动物神经功能障碍恢复加快，血Ｔ３、Ｔ４、ＧＨ和ＰＲＬ异常恢复加快，脑组织中ＳＯＤ、ＭＤＡ异常减轻；组织病理学提示脑水肿减轻，神经元缺血坏死减少，新生毛细血管、吞噬细胞及星形细胞数明显增加，胶质纤维产生增多；大剂量治疗组作用最明显。结论：水蛭对大鼠脑出血急性期有明显治疗作用，且呈量效关系；促进毛细血管和胶质细胞增生并增强其功能是治疗作用的机制之一更多还原

【Abstract】 Objective:To investigate the effect of hirudo (leech) on cerebral hemorrhage and its potential mechanism in rats.Methods:Intracerebral hematoma was induced by stereotaxically injecting 25 μl of autologous blood into left caudate nucleus.Fiftysix adult SD rats (280 g￣360 g) were divided into 6 groups as follows:3 hirudotreated groups with different dosages (approximately crude drug of 900 mg/kg,450 mg/kg,225 mg/kg respectively),2 salinetreated groups (treatment with saline for 7 days and 14 days),and shamoperated group.The severity of defective neurologic function,brain water content,superoxide dismutase(SOD),glutathione peroxidase(GSHPx) activity,malonyldialdehyde(MDA) content in brain tissue,and serum triiodothyronine(T3),tetraiodothyronine(T4),growth hormone(GH),prolactin(PRL),as well as corticosteroid(CS) concentrations were measured in various groups.In addition,the pathologic changes were observed by using electron microscope and light microscope with different stain methods,including hemotoxylineosin,van Gieson,Gomori silver stain,glial fibrillary acidic protein immunostain,etc.Results:In groups treated with hirudo,the recovery of neurologic function was quick compared with the controls.Similarly,serum T3,T4,GH,and PRL concentrations returned to normal values,and the reduction in SOD activity and increase in MDA contents were much less in hirudotreated groups than in control groups.In the treatment groups,pathologic examinations revealed that cerebral edema,necrotic lesions of the nervous tissue,and neuron ischemic changes were attenuated,but the number of newborn capillaries,glial cells,as well as astrocytes were increased obviously with enhancing in the production of neuroglial fibres.All those changes were closely related to the dosage of hirudo.Conclusions:Hirudo has treatment effect on the cerebral hemorrhage during acute phase in rats,showing a dosedependent response.One of the potential mechanisms might be associated with the improvement of capillaries and glial cells hyperplasia.更多还原