人脑挫裂伤后神经细胞凋亡及凋亡相关基因Bcl-2/Bax的蛋白质表达  

Nerve cell apoptosis and expression of Bc1-2/Bax after cerebral contusion/laceration in human beings

作　　者：段磊[1] 王维平[1] 张建生[1] 丁永忠[1] 

机构地区：[1]兰州医学院第二附属医院神经外科,甘肃省兰州市730030

出　　处：《中国临床康复》2003年第16期2280-2281,共2页Chinese Journal of Clinical Rehabilitation

摘　　要：目的研究挫伤脑组织中神经细胞凋亡现象及凋亡相关基因Bcl-2Bax蛋白质表达的变化,探讨创伤后脑组织中是否存在凋亡以及凋亡在脑外伤病理过程中所起的作用。方法采用流式细胞仪检测凋亡,采用免疫组化法检测脑组织中凋亡相关基因Bcl-2/Bax的表达。结果脑组织中神经细胞凋亡与患者的病情严重程度犤格拉斯哥昏迷量表(GCS)评分≥6者凋亡百分数为(1.2±2.1)%,GCS评分<6者为(4.7±2.5)%,t=3.77P=0.001犦及受伤时间犤受伤时间≥24h者凋亡百分数为(5.2±3.5)%受伤时间<24h者为(1.9±2.1)%,t=2.34,P=0.007犦有关,而与患者预后无关(χ2=0.69,P=0.50)。Bcl-2阳性表达与预后有关(Bcl-2阳性表达者15例中死亡1例,阴性表达者11例中死亡6例,χ2=5.161,P=0.023),与患者性别、年龄、GCS评分、受伤时间无关(P>0.05)。凋亡百分数与Bcl-2阳性表达间无相关性(t=0.584,P=0.564)。所有患者Ba均表达阳性。结论创伤后脑组织中存在凋亡,在病理过程中起一定作用,严重程度与患者病情及受伤时间有关,Bcl-2的蛋白表达与预后相关Bcl-2/Bax在神经细胞凋亡的信号传导中起重要作用。Aim To study the apoptosis of nerve cells and changes of Bcl 1/Bax expression related to apoptosis in cerebral tissues after contusion/laceration in human beings.Methods Brain tissue obtained during débridement and/or frontotemporal pole incision and internal decompression from 26 patients with brain contusion/laceration.Flow cytometry (FCM) was used to examine the cell apoptosis.HE staining and immunohistochemistry were used to detect the expression of Bcl 2/Bax.The data of Glasgow coma scale of the patients were obtained.Results The apoptosis percentage was (1.2±2.1)%and (4.7±2.5)%for the patients with the GCS score of ≥6 and< 6 respectively (t=3.77, P=0.001) and the apoptosis percentage was (5.2±3.5)%and (1.9±2.1)%for the patients with the time after injury of ≥24 h and < 24 h respectively (t=2.34, P=0.007). The apoptosis percentage was (2.5±3.1)%and(3.6±2.1)%for the surviving patients and dead patients respectively (χ2=0.69, P=0.50). One of the 15 patients with positive Bcl 1/Bax expression and 6 of the 11 patients with negative Bcl 1/Bax expression died. The expression of Bcl 2 was correlated only to prognosis (χ2=5.161, P=0.023) but not to sex, age, GCS score, and time after injury (all P >0.05).Apoptosis percentage showed no correlation with positive expression of Bcl 2 (t=0.584, P=0.564). All the patients showed positive expression of Bax.Conclusion Apoptosis occurs in human brain after acute injury, which plays an important role in the pathologic process of brain tissue. The severity of apoptosis is related to the patients' condition and time after injury and not to prognosis.The expression of Bcl 2 is correlated with prognosis. Bcl 2/Bax is important in the signal conduction of apoptosis.

关 键 词：人脑挫裂伤 神经细胞凋亡 凋亡相关基因 Bcl-2蛋白质 Bax蛋白质 基因表达 脑外伤 

分 类 号：R651.15[医药卫生—外科学] R394[医药卫生—临床医学]