脑出血后凝血酶与脑水肿关系及水蛭粉的疗效

目的　探讨凝血酶在脑出血后脑水肿形成机制中的作用以及水蛭粉治疗脑水肿的疗效。方法　分别制作大鼠自体全血、凝血酶、肝素抗凝血、生理盐水及假手术脑血肿模型 ,观察不同时间血肿周围脑组织含水量 ,Na+ 、K+ 含量的变化以及病理改变 ;并观察水蛭粉 (2 5 0mg/kg口服 ,每天 2次 ,治疗 5d)治疗脑水肿的疗效。结果　大鼠脑内注射全血或凝血酶后 ,脑组织的含水量、电解质含量的变化相一致 ;在 2 4h时 ,脑水含量、Na+ 含量较其它 3组高 ,而K+ 含量则较低 (P <0 0 5 )。水蛭粉治疗后脑水含量、Na+ 、Ca2 + 含量较对照组降低 ,而K+ 含量升高 (P <0 0 5 )。结论　凝血酶可能在脑出血后脑水肿形成机制中起重要作用 ;水蛭粉对大鼠全血和凝血酶导致脑水肿有显著影响。

Study on correlation of thrombin and cerebral edema following intracerebral hemorrhage and effects of treated with hirudo powder

Objective To observe the role of thrombin in cerebral edema formation following intracerebral hemorrhage and the effect of hirudo powder treatment.Methods Whole boold,heparinized blood,thrombin or saline were infused into the right caudate nucleus of rats in a stereotactic frame.Twenty rats were treated with hirudo powder(250mg/kg,twice daily for 5d,po).Brain water and electrolyte levels in these rats were measured at different times.Results Brain water and sodium content were significantly increased,and potassium content was significantly decreased in the rats infused with whole blood or thrombin.There were obvious differences compared with those of rats infused with heparinized blood or saline or sham-operation group at 24 hours( P <0 05).The content of brain water,sodium and calcium was signifcantly decreased,but potassium content was significantly increased in groups treated with hirudo powder( P <0 05).Conclusion Thrombin may play an important role in the development of edema formation following intracerebral hemorrhage;Hirudo powder may have a signifcant effect on brain edema following intracerebral hemorrhage.