【摘要】 目的:探讨脑梗死组织周围半暗区星形胶质细胞增生及形态学定量分析及意义。方法:回顾性分析临床病理资料完整的高血压引起脑梗死伴继发出血的患者行小骨窗微创开颅手术、石蜡包埋及切片标本63例，以每例梗死伴出血旁正常脑组织为对照组。采用免疫组织化学法检测人体脑梗死周围半暗区胶质纤维酸性蛋白(GFAP)的表达，用图像分析测定GFAP表达的星形胶质细胞数目、细胞体面积、突起长度的变化。结果:在周围正常脑组织中，GFAP标记的阳性星形细胞均匀分布，胞体较小，突起呈分支状较纤细，呈放射状分布；在梗死灶周围半暗区，GFAP标记的阳性星形胶质细胞数目增多，细胞体面积增大，突起增长、互相交织成网，聚集在病灶边缘，并可见少量深入梗死灶。与周围正常脑组织比较，在脑梗死周围半暗区GFAP表达的星形胶质细胞阳性细胞数显著升高、星形胶质细胞体面积明显增大、突起明显增长，差异均有统计学意义(均P<0.01)。直线相关分析显示，在脑出血梗死周围半暗区，GFAP表达的星形胶质细胞阳性细胞数与星形胶质细胞体面积及细胞突起长度无相关性(均P>0.05)。结论:脑梗死组织半暗区星形胶质细胞反应性增生，这些反应性增生的星形胶质细胞形态学特征多样，可表现为细胞体积增大，或仅表现为细胞突起的伸长。间接说明星形胶质细胞参与了梗死灶神经修复和再生的过程。更多还原

【Abstract】 Objective:To investigate the quantitative analysis and significance of astrocyte proliferation and morphology in penumbra around cerebral infarction.Methods:A total of 63 patients with cerebral infarction and secondary hemorrhage caused by hypertension with complete clinicopathological data were retrospectively analyzed.The small bone window minimally invasive craniotomy, paraffin embedding and sectioning specimens were performed in 63 patients.The normal brain tissue adjacent to the infarction and hemorrhage was taken as the control group.Immunohistochemistry was used to detect the expression of glial fibrillary acidic protein(GFAP) in penumbra around cerebral infarction.Image analysis was used to determine the changes of the number of GFAP-expressing astrocytes, cell body area and process length.Image analysis were used to measure the number, the cell body area and the process length of GFAP-expressing astrocytes.Results: In the surrounding normal brain tissue, the positive astrocytes labeled with GFAP were evenly distributed, the cell bodies were small, and the processes were branched and slender, with radial distribution.In the penumbra around the infarct, the number of GFAP labeled positive astrocytes increased, the cell body area increased, the processes increased, interwoven into a network, gathered at the edge of the lesion, and a small amount of deep infarct could be seen.Compared with the normal brain tissue, the number of astrocytes for the positive expression of GFAP,and the cell body area and the process length were increased significantly, respectively, in the cerebral infarcts with boundary zones of human tissues, the difference was statistically significant(all P<0.01).Linear correlation analysis showed that there was no correlation between the number of GFAP-positive astrocytes and the area of astrocytes and the length of astrocytes in the cerebral infarcts of human tissues(all P>0.05).Conclusion:Reactive proliferation of astrocytes in penumbra of cerebral infarction in human tissues.These reactive hyperplastic astrocytes are characterized by a variety of morphological features, which may be manifested by an increase in cell volume or only by the elongation of cell processes.Those indicate indirectly that astrocytes are involved in the process of nerve renovation and regeneration in the infarct.更多还原