去铁胺对大鼠脑室出血后慢性脑积水的疗效观察  

Effect of deferoxamine in treatment of chronic hydrocephalus after intravetricular hemorrhage in rats

作　　者：宫国旗[1] 孟辉[1] 夏永智[1] 冯华[1] 

机构地区：[1]第三军医大学附属西南医院神经外科 全军神经系统疾病微创诊治专科中心,重庆400038

出　　处：《中华创伤杂志》2010年第11期1025-1029,共5页Chinese Journal of Trauma

基　　金：国家“十一五”科技支撑计划资助项目（2006BA101A12）;国家自然科学基金资助项目（30772224,30872674）;西南医院临床研究课题资助项目（SWH20058005）

摘　　要：目的 探讨去铁胺治疗大鼠脑室出血后慢性脑积水（chronic hydrocephalus,CH）的效果.方法 SD雌性大鼠184只,采用随机数字表法分为三组：等渗盐水对照组、侧脑室注血组及侧脑室注血加去铁胺组.采用侧脑室注血法（130μl）制备大鼠脑室出血后CH动物模型,14,28 d时以Morris水迷宫实验检测大鼠学习记忆能力,以术后28 d时前囟后0.4mm冠状面的侧脑室宽度评价脑积水的发生率,分别于术后1,3,7,14及28 d处死大鼠,测量上述平面侧室指数（侧室面积/脑片面积×100）,并观察脑组织病理变化.结果 等渗盐水对照组无脑积水发生;侧脑室注血组28 d脑积水发生率（73%,11/15）高于侧脑室注血加去铁胺组（27%,4/15）（P＜0.05）.等渗盐水对照组28 d时水迷宫时间逃避潜伏期（8.21±2.00）s,短于侧脑室注血组（16.36±5.93）s（P＜0.01）,但与侧脑室注血加去铁胺组（11.38±2.57）s比较,差异无统计学意义;等渗盐水对照组28 d侧室指数值（1.05±0.41）小于侧脑室注血组（4.53±1.70）及侧脑室注血加去铁胺组（2.77±1.53）（P＜0.05）;等渗盐水对照组各时相点无明显病理改变;侧脑室注血组大鼠脑室周围白质水肿,组织细胞增生,胼胝体出现扭曲和肿胀,含铁血黄素侧脑室壁沉积等.侧脑室注血加去铁胺组各时相点表现类似于侧脑室注血组,但未出现含铁血黄素侧脑室壁的沉积.结论 脑室出血后其分解产物铁离子与脑室出血后脑积水的发生有关,而预防性使用去铁胺可减少大鼠脑室出血后CH的发生.Objective To discuss the effect of deferoxamine in the treatment of chronic hydrocephalus （CH） after intraventricular hemorrhage （IVH） in rats. Methods A total of 184 female Sprague Dawley rats were randomly divided into normal saline group （ NS group）, intracerebroventricular blood infusion group （Group A ） and deferoxamine plus intracerebroventricular blood infusion group （ Group B）. The rat CH models were made by infusing autologous whole blood （ 130 μl） into the right lateral cerebral ventricle. The escape latency time was detected by Morris water maze at days 14 and 28.The rats were sacrificed 1,3, 7, 14, 28 days later, the transverse diameter of the lateral ventricle on the coronal slice of rat brain 0.4 mm posterior to the bregma was measured for evaluation of hydrocephalus and the index of ventricle. Pathological changes of the brain were observed. Results No CH was found in the NS group. The incidence of CH in the Group A was 73% （11/15）, which was significantly higher than 27% （4/15） in Group B at day 28. The escape latency time in the NS group was （8.21 ± 2.00） s,which was significantly shorter than （ 16.36 ±5.93 ） s of the Group A （ P 〈0.01 ）. There was no significant difference in the escape latency time between the NS group and Group B [（11.38 ± 2.57 ）s] （P 〉0.05 ）. The index of ventricle in the NS group was 1.05 ± 0.41, which was smaller than 4.53 ± 1.70 in Group A and 2.77 ± 1.53 in Group B （P 〈 0.05 ）. There were no obvious pathological changes in the NS group at different time points. There found edema of white matter surrounding the ventricle, twist and engorged callosum, proliferation of rhagiocrine cell as well as hemosiderin deposit in Group A. However, no hemosiderin deposit was found in Group B. Conclusions The content of iron in the cerebrospinal fluid may be correlated with hydrocephalus after IVH. Preventive use of deferoxamine can reduce incidence of hydrocephalus after ICH.

关 键 词：脑出血 脑积水 去铁胺 

分 类 号：R686[医药卫生—骨科学]