凝血酶神经毒性作用的在体MRI观察  

Neurotoxic effect of thrombin :proved by MRI in rats

作　　者：张新江[1] 易黎 常丽英[3] 殷小平[4] 徐广润[5] 张苏明[4] 方思羽[4] 卢广[6] 刘买力[6] 

机构地区：[1]中国人民解放军兰州军区兰州总医院神经内科,甘肃兰州730050 [2]深圳市北大医院神经内科 [3]襄樊市中心医院神经内科 [4]华中科技大学同济医学院附属同济医院神经内科 [5]山东大学附属齐鲁医院神经内科 [6]中科院武汉物理研究所

出　　处：《中国急救医学》2004年第1期7-9,共3页Chinese Journal of Critical Care Medicine

基　　金：卫生部临床学科重点项目基金资助 (No.970 70 2 41)

摘　　要：目的　研究脑内注射凝血酶的安全性及其引起组织损伤的可能机制。方法　大鼠尾状核注射 5 0 μL不抗凝的自体血 (脑出血组 )或等体积、分别含有凝血酶 1U(小剂量组 )、10U(大剂量组 )的生理盐水 ,通过 4 .7TeslaMRI设备在发病后 30min、2 4h、4 8h、72h动态观察T2 WI、T2 WI、DWI序列显示的病灶、血脑屏障破坏程度 ;通过神经功能缺损评分判断病灶对机体的影响 ;病理观察病灶周围脑组织对伊文思蓝的通透性和白细胞的浸润程度。结果　 2 4h时脑水肿范围 (指注射病灶和血肿周围水肿之和 )在大剂量组〔分别为T2 WI(5 4 .2± 5 .9)mm3 ;DWI(5 8.5± 5 .6 )mm3 )〕、脑出血组〔T2 WI(45 .9± 11.4 )mm3 ;DWI(47.3± 9.1)mm3 〕均明显大于小剂量组〔T2 WI(39.0± 7.7)mm3 、DWI(39.2± 7.0 )mm3 ,P均 <0 .0 0 1〕 ,前二者比较无显著性差异。大剂量组血脑屏障的破坏明显 ,血肿周围中性白细胞浸润出现最早。结论　凝血酶有较强的中性白细胞趋化作用 ,可引起血脑屏障的早期破坏 ,导致血管源性脑水肿的发生。Objective To investigate the neurotoxic effect of thrombin on rat brain and its possible mechanism. Methods After injecting 50 μL autologous blood(cerebral hemorrhage group) , 1unit (1 unit group) or 10 units of thrombin (10 unit group) dissolved in 50μL 0.9% sodium chloride,into rat's caudate nucleus respectively, serial scanning by MRI(on T 2*WI,T 2WI,DWI sequences) was given.The neurologic deficit score was investigated and the damaged BBB was observed by pathology. Results At 24 hours,the average lesion volumes,including both the hematoma and the perihematoma edema, in cerebral hemorrhage group〔T 2WI(54.2±5.9)mm3;DWI(58.5±5.6)mm3〕 and 10 unit goup〔T 2WI(45.9±11.4)mm3;DWI(47.3±9.1)mm3〕were significantly larger than those in 1 unit group〔T 2WI(39.0±7.7)mm3、DWI(39.2±7.0)mm3,P<0.001,respectively〕.The rats in 10 unit group suffered from early and severe damage of BBB.Moreover, a great number of leukocytes could be found in the part of perihematoma.Conclusion Thrombin ,as a neurotoxin,attracting leukocytes into perihematoma and damaging the BBB ,is in charge of the vasogenic edema at 24 hours after hemorrhage.

关 键 词：大鼠 脑出血 核磁共振 凝血酶 脑水肿 

分 类 号：R445.2[医药卫生—影像医学与核医学]