【摘要】 目的研究脑出血患者血肿周围组织补体激活与炎性反应的关系。方法对30例脑出血患者(实验组)在手术时于血肿旁约1cm处取少许脑组织,按发病到手术的时间将实验组分为<6h组(6例),6~12h组(7例),12~24h组(5例),24~72h组(6例),>72h组(6例)。从前2组中选7例患者(对照组)在手术入颅路径上远离血肿处取少许脑组织。应用免疫组化染色,逆转录-聚合酶链反应(RT-PCR)分别观察补体C3和补体抑制剂(Clusterin)的表达与炎性细胞的浸润、胶质细胞增生、炎性细胞因子的表达情况。结果与对照组相比,脑出血患者C3表达高峰在12~72h(P<0.05~0.01),Clusterin表达于12~72h有增高趋势,但无统计学意义;炎性细胞浸润从6~12h逐渐明显,12~72h达高峰(P<0.05~0.01);小胶质细胞、星形胶质细胞于24~72h后增生明显(均P<0.01);肿瘤坏死因子-α(TNF-α)表达于12~72h达高峰(P<0.05~0.01),后逐渐降低。RT-PCR显示:TNF-αmRNA的表达与蛋白表达基本一致;白细胞介素(IL)-1β(IL-1β)和IL-6mRNA表达于12~72h达峰值(均P<0.01)。相关因素分析显示:C3表达与炎性细胞浸润和胶质细胞增生及与细胞因子表达呈显著正相关(r=0.42~0.80;P<0.05~0.01),而Clusterin与上述表达无相关性。结论脑出血患者血肿周围组织补体激活与炎性反应有密切关系。更多还原

【Abstract】 Objective To study the relationship between complement activation and inflammatory reaction in tissues of the perihematoma in patients with intracerebral hemorrhage (ICH).Methods A few tissues near 1cm area around the hematoma in 30 patients (research group) were cut and divided into 5 groups according to the time after ICH, 6,7,5,6,6 patients in 6 h,6~12 h,12~24 h,24~72 h,>72 h goups, respectively. A few tissues distant from the hematoma on the way into the cranium were taken from the 2 former groups as control. Immunohistochemistry staining and reverse transcription polymerase chain reaction (RT-PCR) were used to detected expression of complement facters C3 ,complement inhibitor (Clusterin),the infiltration of the inflammatory cells, the proliferation of neuroglia cells and the expression of cytokins.Results The immunohistochemistry staining showed that the expression of complement facter C3 got to the peak at 12~72 h (P<0.05~0.01) after ICH,the expression of Clusterin began to increase at 12~72 h after ICH,but there was no statistically significant between the two groups ,the infiltration of the inflammatory cells began at 6~12 h and reached the maximum at 12~72 h (P<0.05~0.01).The microglias,satellite cells quantified markedly after 24~72 h(P<0.01) and the expression of tumor necrosis facter-alpha (INF-α) got to the maxium at 12~72 h (P<0.05~0.01),decreased later. RT-PCR indicated that TNf-αmRNA expression were coincident with the protein changes ,the interleukins-1β( IL-1β),IL-6 mRNA got to the maximum at 12~72 h(all P<0.01).The relation analysis indicated that the expression of complemen facter C3 was strongly positively correlative to infiltration of inflammatory cells, the proliferation of neuoglia cells and the expression of cytokins(γ=0.42~0.80,P<0.05~0.01).Clusterin was no dependablity to what had mentioned above.Conclusion There is a close relationship between the complement activation and the inflammatory reaction in the tissues of perihematoma in patients with ICH.更多还原