机械性脑血管痉挛与血管内皮细胞缺血瀑布级联效应的实验观察  

Observation of vessel endotheliocyte reactions in the early stage of acute mechanical cerebral vasospasm

作　　者：潘颖[1] 张绍东[2] 罗芳[3] 张淑珍[3] 

机构地区：[1]首都医科大学生物化学暨分子生物学系,100069 [2]北京市神经外科研究所 [3]首都医科大学附属北京天坛医院麻醉科

出　　处：《中国康复医学杂志》2006年第8期675-677,共3页Chinese Journal of Rehabilitation Medicine

基　　金：北京市自然科学基金资助项目(7992021)

摘　　要：目的:观察术中急性机械性脑血管痉挛,早期(2h)大脑中动脉(MCA)血管内皮细胞的反应。方法:6只猫,眶后入路,暴露右侧MCA,机械刺激30min,观察刺激后不同时段,血管直径的改变;高效液相色谱(HPLC)分析颞叶皮质间隙谷氨酸Glu浓度变化;镜下观察颞叶皮质形态学和MCA血管内皮细胞结构的改变。结果:机械性刺激MCA后,MCA直径缩小,为刺激前的68.78%。脑组织灌流指数下降到刺激前的42.59%。刺激结束后2h,MCA直径恢复正常。脑组织灌流量恢复到刺激前的61.87%。HPLC显示颞叶和枕叶脑组织间隙兴奋性氨基酸急剧升高,光镜下颞叶皮质神经元固缩,血管周围水肿。电镜观察发现,MCA经急性机械性刺激后早期(2h)MCA内皮细胞染色质聚集,凝聚成新月形小体。线粒体嵴模糊不清。结论:机械性刺激猫脑MCA诱发血管痉挛早期(2h)显示内皮细胞的缺血瀑布级联效应,与神经元细胞凋亡相呼应。但是其病理过程与蛛网膜下腔出血、脑卒中引发的血管内皮细胞的凋亡和血管痉挛不同。提示,颅脑手术或动物实验中机械性脑血管痉挛可能影响术后神经功能的康复。Objective：Cerebral vasospasm after subarachnoid hemorrhage or stroke is prolonged contraction that leads to cerebral ischemia or infarction.The studies have shown dystrophy of endotheliocyte. But the reactions of vessel endotheliocyte in the early stage （2 hours after stimulation finished） of acute medianical MCA vasospasm remain unknown. Method：The right MCA of six cats were persistent mechanical stimulated using a small smooth stainless steel nail in the field acrossing the olfactory tract for 30 minutes.The changes of MCA diameter was measured by metrical ocular of microscope. The changes of the perfusion index of brain tissue were observed through the Laser Doppler flowmetry monitor fixed on the skull. The concentration of Glu was examined by HPLC.The ultrastrocture of vessel endotheliocytes were investigated through the electron microscope.Result：The diameter of MCA decreased to 68.76% of normal,two hours later the diameter of MCA recovered. The perfusion index of the cortex surface decreased to 42.95% of normal and up to 61.87% 2 hours later.During this time,the concentration of Glu increased to 46 times of normal. There is no marked difference between the temporal lobe and the occipital lobe. The chromatin of endothliocyte concentration to the side and form the lunular body,2 hours after the mechanical stimulation.Conclusion： Ischemia cascade effect occurred in the endothelial cells in the early stage of acute mechanical cerebral vasospasm.The possible role of endothelial cells in cerebral vasospasm is discussed in this article.

关 键 词：脑血管痉挛 内皮细胞 级联效应 康复 

分 类 号：R743[医药卫生—神经病学与精神病学]