脑挫裂伤时伤灶中白细胞对血脑屏障及病理改变的影响  

Effects of Leukocytes in the Injured Areas on Blood-brain Barrier and Pathological Changes After Brain Contusion in Rats

作　　者：徐立新[1] 刘运生[1] 计绍云[2] 刘劲芳[1] 史保中[1] 

机构地区：[1]中南大学湘雅医院,湖南长沙410008 [2]湖南省常德市第一人民医院,湖南常德415003

出　　处：《医学临床研究》2005年第5期611-613,共3页Journal of Clinical Research

摘　　要：【目的】探讨脑挫裂伤时伤灶中的白细胞对血脑屏障及病理改变的影响,为临床上脑外伤的治疗提供理论依据。【方法】选择健康成年大鼠120只,随机分成三组,即脑外伤组、脑外伤加注全血组、脑外伤加注白细胞组;每组又按处死时间4 h,24 h,72 h,120 h分成四个亚组,每亚组取5 只行水含量与光镜、电镜检查,另5只检测伊文思兰含量。【结果】伤后4 h可见脑水肿,72 h达高峰,在第120 h开始下降,而白细胞组在第120 h仍持续;各时间点比较,白细胞组明显高于脑外伤组;病理学观察可见类似结果。血脑屏障开放呈双相模式,第一次开放于伤后4 h,第二次开放为伤后72 h,且明显高于24 h与120 h;且白细胞组于伤后120 h明显高于脑外伤组与全血组。【结论】脑挫裂伤时,病灶中的白细胞可明显促进脑水肿与血脑屏障开放,加重脑损伤并延长脑水肿的持续时间。ObjectiveTo explore the pathological effects of leukocytes in the injured areas on contusive brain tissue in order to provide theoretical basis of clinical treatment for traumatic brain injury.Traumatic brain injured animal model was established with injection of blood components;120 rats were randomly divided into three groups i.e, traumatic brain injury (TBI)group, whole blood(WB)group and white blood cell(WBC)group. Each group was further divided into four subgroups. All rats were killed at4,24,72,120 hours after injury, pathological changes and water, Evans Blue content of brain tissue in injured areas were examined.There was a peak of brain water content at 3 days after TBI; at 5 days after TBI, brain water content of group WBC was significantly higher than TBI and WB groups (P<0.01); pathologically, the same result was obtained; This study showed that the billd-brain barrier(BBB) opening occured in a biphasic pattern after TBI. The first opening appeared to be maximum at 4h after TBI. At 3 days, a second prominent opening of the BBB occurred and this increase was significant compared to that at 24 h after TBI (P<0.05).[Conclusion]The leukocytes in the injured areas of brain contusion can result in more obviously brain injury and brain edema, and prevent or delay the recovery of brain edema.

关 键 词：脑损伤 挫伤 白细胞 血脑屏障 

分 类 号：R651.15[医药卫生—外科学]