【摘要】 目的　研究脑出血 (intracerebralhemorrhage ,ICH)血肿周围脑组织的糖代谢、氧自由基及血脑屏障 (blood brainbarrier ,BBB)的变化与脑水肿形成的关系 ,从而进一步阐明脑水肿形成的机制。方法　 60只SD雄性大鼠从尾动脉采血 10 0 μL ,在立体定向仪下注入大鼠右侧大脑内囊处 ,制成脑出血模型 ,按脑出血形成的时间分为假手术组、4、8、12、16、2 4、4 8、72、12 0、168h组共 10组。干湿重法测量脑组织含水量。BBB的通透性采用伊文思蓝法。并测定脑组织MDA(丙二醛 )、SOD(超氧化物歧化酶 )和糖、LDH(乳酸脱氢酶 )的水平。结果　血肿周围脑组织含水量在ICH形成 4h就开始升高 (P <0 .0 5 ) ,4 8～ 72h达到高峰 ,5～ 7d逐步恢复正常。EB(伊文思蓝 )在 8h开始升高 ,12h迅速升高 ,2 4～ 4 8h到达高峰。SOD、MDA在 12h开始变化 ,72h最明显。而糖也在 72h达高峰 (P<0 .0 1)。LDH在 8h开始升高 ,72h达到高峰 ,以后缓慢下降。结论　ICH脑水肿形成早期 ( 4～ 8h)主要由于血肿本身释放的毒性物质引起 ,中期 ( 2 4～ 4 8h)主要是由于BBB的破坏引起 ,晚期 ( 72h)则主要由于血肿周围脑组织代谢紊乱及氧自由基的损伤引起更多还原

【Abstract】 Purpose To study the mechanisms of brain edema formation following intracerebral hemorrhage(ICH) and its relationship with effects of metabolic alteration,free radical release and blood brain barrier(BBB) permeability. Methods Sixty adult SD rats were used and each of them was steretactically infused 100 μL auto logous blood taken from rat tail artery into the right basal ganglia.According to the time of the ICH formation,60 rats were divided into 10 groups:sham,4,8,12,16,24,48,72,120,168 h.Water content,EB,SOD,MDA,glucose and LDH in brain tissue around the hematomas were measured. Results The brain edema was obvious at 4 hour after ICH,peaked at 48-72 hour and gradually resolved in 5-7 days.While BBB permeability was obvious at 8 hour,rose rapidly at 12 hour and peaked at 24-48 hour.The change of SOD and MDA was obvious at 12 hour and peaked at 72 hour.The level of glucose also peated at 72 hour( P <0.01).The level of LDH altered at 8 hour and peaked at 72 hour,then descended gradually. Conclusions The early phase (4-8 hour) of brain edema formation after ICH is related to the toxicity released from the hematomas themselves,the middle phase(24-48 hour)is related to the BBB damage,and the late phase(72 hour) is related to the metabolic imbalance and free radical toxicity in the brain.更多还原