阻滞脑淋巴引流加重蛛网膜下腔出血继发性脑损伤的实验研究  

Experimental study on the deterioration of secondary cerebral injury after subarachnoid hemorrhage by blockage of cerebral lymphatic drainage

作　　者：孙保亮[1] 王轩 程子翠[4] 贾丽丽 杨明峰[1] 张颜波[1] 谢方民[2] 曹明志[5] 袁慧[1] 

机构地区：[1]山东省高校脑微循环重点实验室、泰山医学院附属医院神经内科,泰安271000 [2]山东省高校脑微循环重点实验室、泰山医学院附属医院神经外科,泰安271000 [3]济南市第六人民医院 [4]山东省泰安市中医医院 [5]济宁医学院附属湖西医院神经外科

出　　处：《中华神经外科杂志》2010年第1期12-15,共4页Chinese Journal of Neurosurgery

基　　金：基金项目：国家自然科学基金（30570651,30670724）;山东省教育厅科技计划项目（J05L10）;山东省中医药科技发展计划项目（2005-231）;山东省卫生系统高层次人才基金资助项目

摘　　要：目的探讨脑淋巴引流途径在蛛网膜下腔出血（SAH）继发性脑损伤中的作用。方法将大鼠分为对照组、SAH组、SAH＋脑淋巴引流阻滞（CLB）组。监测血气、血压和颅内压，3d后观察脑实质局部脑血流量（rCBF），检测大脑皮层细胞凋亡、caspase-3mRNA和caspase-3表达。结果SAH组颅内压急剧升高，SAH＋Club组颅内压升高更显著；SAH后rCBF降低，CLB加重rCBF下降；SAH后大脑皮层有较多凋亡细胞，SAH＋CLB组细胞凋亡更严重；SAH组大脑皮层caspase-3mRNA和caspase-3表达增加，SAH＋CLB组caspase-3mRNA和caspase-3表达进一步增强。结论脑淋巴引流途径阻滞可加重SAH继发性脑损伤，该途径在SAH时可能起到内源性保护作用。Objective To investigate the role of cerebral lymphatic drainage on secondary cerebral injury following subarachnoid hemorrhage （SAH）. Method Rats were divided into control, SAH and SAH ＋ cerebral lymphatic blockage （CLB） groups. Blood gas, blood pressure, and intracranial pressure （ICP） were monitored during the experiment. On the third day after second cisternal injection,regional cerebral blood flow （rCBF） was monitored. Apoptosis, expression of caspase - 3 mRNA and its protein in the cortex were observed. Results An immediate and drastic increase of ICP was noted in SAH group. The increase of ICP in SAH ＋ CLB group was more obvious. SAH resulted in decrease of rCBF and more remarkable decrease of ,EBF was found in SAH ＋ CLB group. Apoptosis in SAH group and more severe apoptosis in SAH ＋ CLB group in cerebral cortex were observed. Increased expression of caspase - 3 mRNA and caspase - 3 protein in cortex was noted in SAH group. The increases in SAH ＋ CLB group were even more striking. Conclusions Blockage of cerebral lymphatic drainage deteriorates secondary cerebral injury after SAH. Cerebral lymphatic drainage pathway may exert protective effects against cerebral injury during SAH.

关 键 词：蛛网膜下腔出血 颅脑损伤 脑淋巴引流 细胞凋亡 CASPASE-3 

分 类 号：R651.1[医药卫生—外科学]