水通道蛋白-4在人脑挫裂伤早期脑水肿的作用机制探讨  

The Mechanism of AQP4 in Early Brain Edema after Contusion and Laceration

作　　者：李新军[1] 韩杨云[1,2] 徐宏[1] 孙中书[1] 周增俊[1] 龙晓东[1] 杨与敏[1] 邹林波[1] 

机构地区：[1]德阳市人民医院神经外科,四川德阳硕士618000 [2]四川大学华西医院神经外科,成都610041

出　　处：《西南军医》2012年第6期827-830,共4页Journal of Military Surgeon in Southwest China

摘　　要：目的探讨人脑挫裂伤后早期AQP4在脑水肿形成中的作用机制,为颅脑损伤后脑水肿的治疗和预后提供客观依据。方法选取经颅脑CT证实为脑挫裂伤且需手术治疗的患者。手术过程中切取脑挫裂伤区组织标本60例为观察组,10例非功能区相对正常脑组织标本为对照组。对照组不做任何处理,观察组按伤后时间分为2 h、6h、8h、12 h、24 h、72h 6个亚组,每组10只(n=10)。采用免疫组化和图像分析技术测定各组相应时间点水肿区AQP4的表达水平,同时用干湿重法检测脑水肿含水量。结果与对照组相比较,观察组在伤后2 h AQP4表达开始增加(P<0.05),6h、8h、12 h明显增加(P<0.01),24h-72h达到最高(P<0.01)。AQP4表达与脑含水量的变化规律趋于一致(r=0.912,P<0.01)。结论脑挫裂伤后AQP4表达明显增强,提示AQP4可能与颅脑损伤的发生、发展过程密切相关,在损伤后脑水肿的形成过程中起重要作用。Objective To discuss the mechanism of aquaporin-4 （AQP4） in early brain edema after contusion and laceration so as to provide objective bases for the treatment of brain edema after craniocerebral injury and for the prognosis. Methods Patients with contusion and laceration of brain confirmed by CT scanning in need of surgery were selected; 60 tissue samples were taken from the site of contusion and laceration （observation group） and 10 normal brain tissue samples were taken from non-functional area of the brain （control group）; observation group was further divided into 6 sub-groups according to the time points after injury： group 2h, group 6h, group 8h, group 12h, group 24h and group 72h, 10 samples in each; immunohistochemical analysis and image analysis were applied in detecting the expression of AQP4 in edema area in each sub-groups and the water content in brain was measured. Results The expression of AQP4 in observation group started increasing 2 hours after injury （P〈O.05）, the in- crease became significant at the time point of 6, 8 and 12 hours （P〈O.O1） and reached the highest during the period from the time point of 24 hours after injury to 72 hours （P〈0.01）; the changes of AQP4 expression and those of wa- ter content of brain were consistent （r=0.912, P〈0.01）. Conclusions The obvious increase of AQP4 expression af- ter contusion and laceration of brain indicates that AQP4 may be in close relation with the occurrence and progress of craniocerebral injury and play an important role in the formation of brain edema after injury.

关 键 词：脑挫裂伤 AQP4 脑水肿 

分 类 号：R651.1[医药卫生—外科学]