【作者】 郑家地；

【导师】 孙树杰；

【作者基本信息】 大连医科大学 ， 外科学， 2006， 硕士

【摘要】 目的:脑出血是神经系统的常见疾病,是影响人类生存及生活质量的最严重的疾病之一。脑出血具有发病率高、病残率高、病死率高的特点。出血后脑组织细胞的死亡方式既有坏死又有凋亡,其中细胞凋亡作为一种基因调控的细胞死亡方式参与了脑出血后继发性脑损伤的病理过程。进一步研究脑出血后细胞凋亡的规律和如何早期抑制细胞凋亡以促进神经功能的恢复对指导临床治疗有重要意义。本实验旨在探讨脑出血后双侧大脑半球纹状体区细胞凋亡的时程变化规律和早期立体定向血肿抽吸术干预治疗对细胞凋亡的影响,试图寻求脑出血治疗的最佳手术时间窗。方法:取健康雄性Sprague-Dawley(SD)大鼠164只,其中将80只SD雄性大鼠随机分成6组,第1组为正常对照组,第2组为假手术组,第3组为脑出血自然恢复组,第4组为6小时血肿抽吸组,第5组为12小时血肿抽吸组,第6组为24小时血肿抽吸组。对照组为正常大鼠;将Ⅶ型胶原酶0.4Units立体定向注入大鼠尾壳核内建立脑出血模型;正常大鼠生理盐水代替胶原酶尾壳核注入作为假手术组。其余各组分别在注入Ⅶ型胶原酶后6小时、12小时、24小时进行血肿抽吸术,运用(terminal deoxynucleotidy1 transferase mediated dUTP nick-end-labeling ) TUNEL法检测细胞凋亡数。64只大鼠用于测定脑组织含水量,20只大鼠用于测定脑内血肿的体积。各组大鼠到相应的时间点时完成Bederson神经行为学评分后断头取脑。结果:1.血肿体积:脑出血后第三天,血肿抽吸血肿体积明显小于自然恢复组(P<0.01);3个抽吸组血肿体积之间无统计学差异。2.脑组织含水量:6h、12h血肿抽吸组出血后3d的脑组织含水量低于自然恢复组(P<0.05),但仍高于正常组(P<0.05);6h抽吸组脑出血后3d的含水量低于24h血肿抽吸组(P<0.05)。3.行为学:6h抽吸组脑出更多还原

【Abstract】 Objective:Intracerebral hemorrhage (ICH) is a common disease in nervous systerm, and it influences survival and live standard for human being. It is characteristic of high attack rate、disability rate、case fatality rate for ICH. The death way for neuron has two ways, necrosis and apoptosis. Apoptosis as a form of cell death that gene regulate involves the pathological process of secondary brain injury. It is significant that studying the regulation of apoptosis and how to inhibit apoptosis for promoting recovery of nervous function. Objective for the experiment is to investigate the changes of apoptosis expression with time in bilateral cerebral striatum of rats caused by intracerebral hemorrhage and the influence of early treatment with hematoma aspiration on apoptosis. And search the optimal time window of surgery after intracerebral hemorrhage.Method: In this experiment 164 mature male Sprague-Dawley rats were used. 80 rats were randomly divided into normal control group , false operation group , natural recovery group and 6hour、12 hour、24 hour hematoma aspiration group. In false operation group , normal saline instead of bacterial collagenase was injected into normal rats caudate nucleus. In normal control group , the animals were normal rats. Establishment of cerebral hemorrage : intracerebral hemorrhage was induced by injection of bacterial collagenase 0.4U into the caudate nucleus.About other groups hematoma was aspirated on 6hour、12hour、24hour respectively. The apoptotic cells in brain tissues were measured by TUNEL method. 64 rats were used to measure the brain water. 20 rats were used to measure the volume of the hematoma. Animals were sacrificed at 3d, 7d, 11d after collagenase injection respectively after behavioral function evaluation.更多还原