摘要
目的 探讨微创血肿抽吸治疗对锥体束修复和神经功能改善的作用.方法 雄性SD大鼠48只按随机数字表法分为正常对照组（n=8）、假手术组（n=8）、脑出血自然恢复组和脑出血后6、12、24 h微创血肿抽吸组（n=8）,后4组大鼠注射Ⅳ型胶原酶-肝素混合液建立基底节脑出血模型,假手术组注射等量生理盐水.造模后6、12、24 h行微创血肿抽吸治疗后3组大鼠.2周后按照＂楼梯测试＂前肢功能的测试方法对各组大鼠进行前肢功能评分,免疫组化染色观察内囊后肢锥体束神经丝蛋白（NF）和神经生长相关货白（GAP-43）的表达.结果 各组大鼠造模前左前肢抓取能力比较差异无统计学意义（P＞0.05）,造模后14 d微创血肿抽吸组前肢抓取功能均高于自然恢复组,其中6 h抽吸组高于12、24 h抽吸组,差异有统计学意义（P＜0.05）;免疫组化染色结果显示微创血肿抽吸组NF染色阳性纤维、GAP-43的表达明显多于脑出血自然恢复组,6 h抽吸组NF染色阳性纤维多于12、24 h抽吸组,差异有统计学意义（P＜0.05）,而6 h和12 h抽吸组GAP-43的表达高于24 h抽吸组,差异有统计学意义（p＜0.05）.结论 脑出血后24 h内,尤其是6 h内予以微创血肿抽吸治疗能减轻内囊后肢锥体束的损伤,利于锥体束的修复,改善神经功能.
Objective To explore the effects of the minimally invasive hematoma aspiration on the repair of the pyramidal tract and improvement of neurological function. Methods Forty-eight SD male rats were equally randomized into normal control group, sham-operated group, cerebral hemorrhage group （model）, model ＋ minimally invasive hematoma aspiration at the 6^th, 12^th, and 24th h groups （n=8）.Intracerebral hemorrhage in the later 4 groups was induced by injection of type IV collagenase ＋ heparin into the caudate nucleus of rats, and the same amount of normal saline was injected into the sham-operated group. And then, the hematoma was lysed by injection of urokinase into the hematoma center 6, 12 and 24 h after intracerebral hemorrhage in the later 3 groups, respectively. Animals were sacrificed after behavioral function evaluation 14 d after collagenase injection. Immunohistochemistry was performed to observe the expressions of neurofilament （NF） and growth associated protein-43（GAP-43） in the posterior limb of internal capsule. Results The snatch ability of left forelimb among all the groups showed no significant differences before the success of model making （P〉0.05）. The snatch ability of left forelimb in each hematoma aspiration group was much higher than that in the model group on the 14^th d of collagenase injection （P〈0.05）. Within the hematoma aspiration groups, the snatch ability in the group performed hematoma aspiration at the 6th h was higher than those group at the 12th and 24th h （P〈0.05）. The number of NF positive fibers and the expression of GAP-43 in the 3hematoma aspiration groups were much larger or higher than those in the model group （P〈0.05）; the number of NF positive fibers in the group performed hematoma aspiration at the 6th h was larger than that in those group at the 12th and 24th h （P 〈0.05）; The expression of GAP-43 in the group performed hematoma aspiration at the 6^th and 12^th h was higher than that in the group at the 24th h （P〈0.05�
出处
《中华神经医学杂志》
CAS
CSCD
北大核心
2010年第12期1212-1216,共5页
Chinese Journal of Neuromedicine
关键词
脑出血
锥体束
微创血肿清除术
Intracerebral hemorrhage
Pyramidal tract
Minimally invasive hematoma aspiration
