基底动脉中Caspase3、8的表达与蛛网膜下腔出血后脑血管痉挛的关系

目的探讨天冬氨酸特异性半胱氨酸蛋白酶3、8(Caspase3、8)在蛛网膜下腔出血(SAH)后在基底动脉中的表达及其与脑血管痉挛的关系。方法新西兰大白兔36只,随机分成对照组(n=6)和实验组(n=30),后者再随机分为SAH后1、3、5、7、10d等5个亚组,每亚组各6只。采用枕大池二次注血法建立SAH模型,应用免疫组化和末端脱氧核苷酸转移酶介导的dUTP原位切口末端标记法分别检测基底动脉内皮细胞Caspase3、8表达和凋亡。结果凋亡细胞在实验组SAH后第1天出现,第7天凋亡水平达到最高。实验组Caspase3、8表达水平明显高于与对照组(P<0.05)。Caspase3、8的表达在SAH后第1天就可观察致到,第5天和第7天出现强烈表达,第l0天表达明显减弱。结论本结果提示在兔脑血管痉挛的基底动脉中存在细胞凋亡;Caspase3、8可能参与了SAH后脑血管痉挛的发生和发展。     

Caspase inhibitors prevent endothelial apoptosis and cerebral vasospasm in dog model of experimental subarachnoid hemorrhage.

Apoptosis in the endothelium of major cerebral arteries may play a role in the initiation and maintenance of cerebral vasospasm after subarachnoid hemorrhage (SAH). We tested the therapeutic effect of caspase inhibitors on endothelial apoptosis and on cerebral vasospasm in an established dog double-hemorrhage model. Thirty-one mongrel dogs were divided into five groups: control; SAH; SAH treated with vehicle [DMSO]; SAH treated with Ac-DEVD-CHO [a specific caspase-3 inhibitor]; and SAH treated with Z-VAD-FMK [a broad caspase inhibitor]. The inhibitors (100 microM) were injected into the cisterna magna daily from Day 0 through Day 3. Angiography was performed on Day 0 and Day 7. Histology, TUNEL staining, and immunohistochemistry were conducted on basilar arteries collected on Day 7 after SAH. Positive staining of TUNEL, poly(ADP)-ribose polymerase (PARP), caspase-3, and caspase-8 was observed in the endothelial cells of the spastic arteries. Double fluorescence labeling demonstrated co-localization of TUNEL with caspase-3 and TNFalpha receptor-1 (TNFR1). Ac-DEVD-CHO and Z-VAD-FMK prevented endothelial apoptosis and reduced angiographic vasospasm. The mechanism of apoptosis in endothelial cells involves TNFR1 and the caspase-8 and caspase-3 pathways. Caspase inhibitors may have potential in the treatment of cerebral vasospasm.     

The effect of mexiletine on the level of lipid peroxidation and apoptosis of endothelium following experimental subarachnoid hemorrhage

OBJECTIVE: The role of apoptosis in etiopathogenesis of vasospasm is not clearly understood yet. It is widely accepted that protection of the endothelial cells from the process of apoptosis could have beneficial effects on cerebral vasospasm after subarachnoid hemorrhage (SAH). Mexiletine blocks sodium and calcium channels and activates ATP-sensitive K(+) channels. Moreover, mexiletine is known to have potent antioxidant effects through inhibiting free-radical production. METHODS: Twenty-one rabbits were allocated into three groups randomly. Group I was sham operated group (n=7). SAH occurred but no medication was given to the Group II rabbits (SAH only group) (n=7). Mexiletine (50 mg/kg, b.i.d., i.p.) was administered just before SAH and continued until 48 hours following SAH to the Group III rabbits (Mexiletine treated group) (n=7). The ApopTag peroxidase in situ apoptosis detection kit (Serologicals Corporation, former Intergen) was used to demonstrate apoptosis in a cross section of basillary arteries. Thiobarbituric acid reactive material was used to determine the lipid peroxidation levels. RESULTS: There was a statistically significant difference between lipid peroxidation product levels of the control and SAH only groups (p<0.05). The level of lipid peroxidation production in Mexiletine treated group was significantly lower compared with SAH only group (p<0.05) but not significantly higher than the control group (p>0.05). DISCUSSION: In the present study we investigated the antioxidant action of mexiletine on apoptosis of endothelium following a rabbit SAH model. This experimental study directly suggested that lipid peroxidation is an important step in development of apoptosis in endothelial cells and prevention of structural integrity of endothelial cell should play a beneficial role in attenuation of cerebral vasospasm. Mexiletine treatment prevented the increase in lipid peroxidation and cerebral vasospasm. Examination of endothelial cells by staining specific for apoptosis demonstrated significant protection of cell integrity in the treated group.     

Role of p53 and apoptosis in cerebral vasospasm after experimental subarachnoid hemorrhage.

Our previous studies indicate that apoptosis in endothelial cells of major cerebral arteries contributes to cerebral vasospasm after subarachnoid hemorrhage (SAH). This study examined the pathologic roles of tumor suppressor p-53 in cerebral vasospasm using an established dog double-hemorrhage model. Twenty mongrel dogs were divided into four groups: (1) control, (2) SAH, (3) SAH+DMSO (vehicle), and (4) SAH+pifithrin-alpha (PFT) (p53 inhibitor). The p53 inhibitor (200 nmol/L) was injected into the cisterna magna daily from Day 0 through Day 3. Angiogram was performed on Day 0 and Day 7. Western blot, cell proliferation assay, histology, and TUNEL staining were conducted on the basilar arteries collected on Day 7 after SAH. The arterial diameter on Day 7 was 42%+/-4%, 40%+/-5%, and 59%+/-4% for SAH, SAH+DMSO, and SAH+PFT, respectively. In addition, positive staining of TUNEL and increased protein expression of p53, Bax, and PCNA in the basilar artery were observed on Day 7. PFT suppressed apoptosis in endothelial cells and proliferation in smooth muscle cells, and attenuated angiographic vasospasm. In conclusion, p53 may be a key factor in endothelial apoptosis and smooth muscle proliferation after SAH. Inhibition of p53 may potentially reduce or even prevent cerebral vasospasm.     

Intracisternal administration of SB203580, a p38 mitogen-activated protein kinase inhibitor,attenuates cerebral vasospasm via inhibition of tumor-necrosis factor-α

Tumor-necrosis factor-α (TNF-α) is critical to the development of cerebral vasospasm after subarachnoid hemorrhage (SAH). Hence, therapeutic strategies targeting TNF-α can attenuate cerebral vasospasm. This study investigated the effects of SB203580, a p38 mitogen-activated protein kinase (MAPK) inhibitor, on TNF-α concentration in the cerebral arteries and the cerebrospinal fluid (CSF) after SAH and on subsequent cerebral vasospasm. Twenty-three rabbits were divided into four groups: (i) control (without SAH), (ii) SAH (SAH only), (iii) dimethylsulfoxide (DMSO, vehicle), and (iv) SB203580. The severity of vasospasm and the immunoreactivities of TNF-α and phosphorylated p38 MAPK in the brain vessels were determined in all animals, and the concentrations of TNF-α in the CSF were also assessed. Severe vasospasm was observed in the rabbits from the SAH and DMSO groups. SB203580 reversed vasospasm after SAH. Lower immunoreactivities of TNF-α and phosphorylated p38 MAPK were found in the basilar artery in the SB203580 group than in the DMSO group. The concentration of TNF-α in the CSF increased after SAH, but treatment with SB203080 after SAH suppressed this increase. Our data show that SB203580 reversed cerebral vasospasm by inhibiting the phosphorylation of p38 MAPK in the basilar artery and by suppressing the increase in TNF-α in the basilar artery and CSF after SAH. SB203580 could therefore potentially be used for the treatment of cerebral vasospasm after SAH.     

2-methoxyestradiol reduces cerebral vasospasm after 48 hours of experimental subarachnoid hemorrhage in rats

2-Methoxyestradiol (2ME2), a naturally occurring metabolite of estradiol, is known to have antiproliferative, antiangiogenic, and antiproapoptotic activities. Mechanistically, 2ME2 has been shown to downregulate hypoxia-inducible factor 1alpha (HIF-1alpha). We hypothesized that hypoxia in the major cerebral arteries might activate a unique signaling pathway, hypoxia-inducible factor-1alpha (HIF-1alpha), to produce or enhance cerebral vasospasm after subarachnoid hemorrhage (SAH). Sprague-Dawley male rats (n = 70) were randomly divided into 5 groups: Sham operated, SAH without treatment, SAH treated with vehicle (DMSO), SAH treated with two HIF-1alpha inhibitors, 2ME2, and D609 (positive control of 2ME2). SAH model was produced by middle cerebral artery perforation. 2ME2 and D609 were administered intraperitoneal at 1 h after SAH; rats were sacrificed after 48 h of SAH. Thick blood clot was observed around basilar artery under arachnoids in all animals except Sham group; severe morphological vasospasm was observed in basilar arteries in SAH and SAH+DMSO rats, and the mild vasospasm in rats treated with 2ME2 and D609; 2ME2 and D609 reduced the activity of HIF-1alpha in the basilar arteries by HIF-1alpha DuoSet ELISA; reduce the expression of HIF-1alpha, VEGF, BNIP3 and PCNA in basilar arteries by Western blotting and immunohistochemical staining. In addition, it decreased the mortality and improved the neurological deficits. In conclusion, 2ME2 is a powerful agent to reduce cerebral vasospasm by inhibiting HIF-1alpha activity and the expression of VEGF as its downstream, suppressing endothelium and VSMCs apoptosis via BNIP3 pathway, and attenuating vasoproliferation.     

The effect of mexiletine on the level of lipid peroxidation and apoptosis of endothelium following experimental subarachnoid hemorrhage

Abstract

Objective: The role of apoptosis in etiopathogenesis of vasospasm is not clearly understood yet. It is widely accepted that protection of the endothelial cells from the process of apoptosis could have beneficial effects on cerebral vasospasm after subarachnoid hemorrhage (SAH). Mexiletine blocks sodium and calcium channels and activates ATP-sensitive K+ channels. Moreover, mexiletine is known to have potent antioxidant effects through inhibiting free-radical production.

Methods: Twenty-one rabbits were allocated into three groups randomly. Group I was sham operated group (n=7). SAH occurred but no medication was given to the Group II rabbits (SAH only group) (n=7). Mexiletine (50 mg/kg, b.i.d., i.p.) was administered just before SAH and continued until 48 hours following SAH to the Group III rabbits (Mexiletine treated group) (n=7). The ApopTag peroxidase in situ apoptosis detection kit (Serologicals Corporation, former Intergen) was used to demonstrate apoptosis in a cross section of basillary arteries. Thiobarbituric acid reactive material was used to determine the lipid peroxidation levels.

Results: There was a statistically significant difference between lipid peroxidation product levels of the control and SAH only groups (p<0.05). The level of lipid peroxidation production in Mexiletine treated group was significantly lower compared with SAH only group (p<0.05) but not significantly higher than the control group (p>0.05).

Discussion: In the present study we investigated the antioxidant action of mexiletine on apoptosis of endothelium following a rabbit SAH model. This experimental study directly suggested that lipid peroxidation is an important step in development of apoptosis in endothelial cells and prevention of structural integrity of endothelial cell should play a beneficial role in attenuation of cerebral vasospasm. Mexiletine treatment prevented the increase in lipid peroxidation and cerebral vasospasm. Examination of endothelial cells by staining specific for apoptosis demonstrated significant protection of cell integrity in the treated group.     

促红细胞生成素对大鼠蛛网膜下腔出血后血管痉挛的防治作用

目的 探讨促红细胞生成素（EPO）对大鼠蛛网膜下腔出血（SAH）后脑血管痉挛（CVS）的影响及其机制。方法 将60只成年SD大鼠随机分为正常组（6只）、假手术组（18只）、SAH组（18只）、EPO组（18只）;假手术组、SAH组合EPO组根据取材时间有分为1、3、7 d三亚组,每亚组6只。采用枕大池二次注血法建立SAH模型。EPO组建模成功后30 min内腹腔注射EPO（3 000 IU/kg,1次/d）。建模成功后1、3、7 d采用取材基底动脉行HE染色测量基底动脉管径及管壁厚度,采用免疫组化检测基底动脉血管壁核转录因子-κB（NF-κB）及内皮细胞型一氧化碳合酶（eNOS）的表达。结果 SAH后1、3、7 d,假手术组基底动脉管径、管壁厚度、NF-κB和eNOS表达水平与正常组无统计学差异（P>0.05）;与假手术组相比,SAH组各时间点基底动脉管径均明显减小（P<0.05）,管壁厚度均明显增加（P<0.05）,NF-κB表达水平均明显增加（P<0.05）,eNOS表达水平均明显降低（P<0.05）;与SAH组相比,EPO组基底动脉管径、管壁厚度均明显改善（P<0.05）,NF-κB表达水平均明显降低（P<0.05）,eNOS表达水平均明显增加。结论 EPO能够显著改善大鼠SAH后CVS,机制可能是通过上调eNOS的表达、抑制NF-κB的表达来实现的。     

不同浓度氧合血红蛋白对大鼠蛛网膜下腔出血后迟发性脑血管痉挛的影响

目的 观察不同浓度氧合血红蛋白对大鼠蛛网膜下腔出血(subarachnoid hemorrhage,SAH)后迟发性脑血管痉挛(delayed cerebral vasospasm,DCV)的影响.方法 将24只大鼠分为三组,对照组(8例)、动脉血SAH组(8例)、静脉血SAH组(8例),分别用枕大池二次注血法将0.3...     

细胞凋亡对蛛网膜下腔出血后脑血管痉挛发病机制的研究

脑血管痉挛是蛛网膜下腔出血的重要并发症,也是造成患者死亡和致残最重要的原因.脑血管痉挛已经成为临床研究的热点,尤其是近几年在发病机制、诊断和治疗方面取得了很大进展.凋亡不同于坏死,是细胞的程序性死亡.最近的研究表明蛛网膜下腔出血以后脑血管内皮细胞存在有凋亡的发生,而且此现象在血管痉挛形成机制中起着重要的作用.对脑血管痉挛凋亡机制的深入研究,必将有助于临床上防治脑血管痉挛.     

The effects of endothelin antagonist BQ-610 on cerebral vascular wall following experimental subarachnoid hemorrhage and cerebral vasospasm

Abstract. Endothelin, a potent vasoconstrictor, has been found to increase in the cerebrospinal fluid and serum of patients following subarachnoid hemorrhage (SAH) and to play a major role in the development of cerebral vasospasm. The aim of this study is to investigate the role of endothelin-A antagonist BQ-610 in the experimentally performed cerebral vasospasm following SAH. Thirty New Zealand rabbits were divided into three groups (each n = 10): group A, control group; Group B, SAH group; Group C, treatment (endothelin antagonist BQ-610 treated) group. In the study, the rabbits developed vasospasm after injection of intracisternal autolog blood into the cisterna magna. After cerebral vasospasm development, in group C, endothelin antagonist BQ-610 was injected intracisternally. Morphometrically, basilar artery lumen was constricted 25% and 62% compared to the control group (group A) in the endothelin treated group (group C) and the endothelin untreated group (group B), respectively. Histopathological findings of the basilar artery wall confirmed the therapeutic effect of endothelin antagonist in vasospasm development. Endothelin-A receptor antagonist BQ-610 has a therapeutic effect in the cerebral vasospasm following experimentally performed subarachnoid hemorrhage when used intracisternally.     

Therapeutic potential of peroxisome proliferator-activated receptor γ agonist rosiglitazone in cerebral vasospasm after a rat experimental subarachnoid hemorrhage model

The pathogenesis of cerebral vasospasm is closely associated with inflammation and immune response in arterial walls. Recently, the authors proved the key role of Toll-like receptor (TLR)4 in the development of vasospasm in experimental subarachnoid hemorrhage (SAH) model. Because peroxisome proliferator-activated receptor (PPAR) gamma agonists are identified as effective inhibitors of TLR4 activation, we investigated the anti-inflammation properties of PPAR-gamma agonist rosiglitazone in basilar arteries in a rat experimental SAH model and evaluated the effects of rosiglitazone on vasospasm. Inflammatory responses in basilar arteries were assessed by immunohistochemical staining for intercellular molecule (ICAM)-1 and myeloperoxidase (MPO). Expression of TLR4 was determined by western blot analysis. The degree of cerebral vasospasm was evaluated by measuring the mean diameter and cross-sectional area of basilar arteries. Rosiglitazone suppressed the SAH-induced inflammatory responses in basilar arteries by inhibiting the TLR4 signalling. Furthermore, rosiglitazone could attenuate cerebral vasospasm following SAH. Therefore, we suggested that PPAR-gamma agonists may be potential therapeutic agents for cerebral vasospasm.     

促红细胞生成素后处理在兔蛛网膜下腔出血中的作用

目的 探讨促红细胞生成素(EPO)后处理对家兔蛛网膜下腔出血(SAH)后脑血管痉挛的逆转作用.方法 30只新西兰白兔按照随机数字表法分为5组:Sham组、SAH0组、SAH1组、SAH2组、SAH3组.Sham组假穿刺,其他4组行枕大池穿刺注血的方法造模.Sham组和SAH0组造模24 h后静脉单次注入生理盐水0.1 mL/kg,SAH1组、SAH2组、SAH3组分别静脉单次注入EPO 500 IU/kg、1000 IU/kg、2000 IU/kg.所有动物存造模完成后48 h处死,使用Image Pro Plus 6.0图像分析系统测量分析并比较不同组问基底动脉管腔面积、基底动脉收缩系数以及海马CAI区神经元密度.结果基底动脉形态学观察结果可见Sham组血管管壁无增厚、无增生或坏死:SAH0组、SAH1组血管壁明显增厚,结构紊乱,中膜明显变厚,平滑肌排列紊乱;SAH3组血管内弹力膜皱折,SAH2组血管改变介于SAH1和SAH3组之间.基底动脉管腔面积SAH2组[(0.10±0.01)mm2]、SAH3组[(0.16±0.02)mm2]较SAH0组[(0.07±0.02)mm2]明显增大,基底动脉收缩系数SAH2组(1.22±0.06)、SAH3组(1.15±0.03)较SAH0组(1.31±0.09)明显减小,海马神经元密度SAH3组[(126.8±5.7)个/mml较SAH0组[(99.3±9.6)个/mm]明显增大,差异均有统计学意义(p<0.05).结论 在SAH后24h,单次静脉注射EPO不仅可以逆转家兔基底动脉痉挛,还可以减轻其脑神经细胞损伤.     

蛛网膜下腔出血后白细胞介素-8基因在兔脑基底动脉中表达的变化

目的探讨实验性蛛网膜下腔出血（SAH）诱发脑血管痉挛时,白细胞介素-8（IL-8）基因在兔脑基底动脉中表达的变化及在诱发脑血管痉挛中的作用。方法35只健康日本大耳白兔随机分为生理盐水组、SAH组。SAH组根据第一次注血时间又分为四组,分别为第一次注血后第1、4、7、14天。以枕大池二次注血法构建迟发性脑血管痉挛模型,采用RT—PCR法观察兔基底动脉中细胞因子IL-8mRNA表达的变化。结果IL-8mRNA在SAH组第一次注血后第4—7天升高,14天趋于正常。SAH组IL-8的表达水平与基底动脉的狭窄程度呈正相关（r=0．642,P〈0．01）。结论IL．8在基底动脉中的表达水平与脑血管痉挛的程度紧密相关,提示IL-8可能作为免疫／炎症因素因素参与了SAH后迟发性脑血管痉挛的发生。     

丹红注射液对大鼠蛛网膜下腔出血后脑血管痉挛的影响

目的 探讨丹红注射液对大鼠蛛网膜下腔出血（SAH）后脑血管痉挛（CVS）的防治作用。方法 将84只健康成年SD 大鼠随机分成4 组:正常组（n=12）、生理盐水组（n=24）、SAH组（n=24）和丹红组（n=24）;后3组根据造模后取材时间,各分为造模后3 d和7 d两亚组,每亚组12只大鼠。采用枕大池二次注血法建立大鼠SAH 模型。丹红组在造模后每天给予一次丹红注射液腹腔注射治疗。按上述时间点灌注固定后取大鼠脑桥段基底动脉,行HE染色,400倍光镜下观察,并测量基底动脉内径、血管壁厚度。结果 造模后3 d、7 d,生理盐水组基底动脉内径、管壁厚度与正常组均无明显变化（P>0.05）。造模后3 d,与生理盐水组相比,SAH组和丹红组基底动脉内径明显缩小,管壁厚度明显增加（P<0.05）;但SAH组和丹红组之间无统计学差异（P>0.05）。造模7 d后,SAH组基底动脉内径近一步缩小（P<0.05）,管壁厚度进一步增加（P<0.05）;而丹红组基底动脉内径较SAH组明显增加（P<0.05）,管壁厚度明显变薄（P<0.05）。结论 丹红注射液对大鼠SAH后CVS有一定的缓解作用。     

实验性蛛网膜下腔出血后脑血管痉挛兔基底动脉Cx43蛋白表达的时相变化

目的 通过建立兔二次蛛网膜下腔出血实验模型,观察兔蛛网膜下腔出血后基底动脉缝隙连接蛋白Cx43表达的时相变化特点,初步探讨蛛网膜下腔出血后脑血管痉挛的形成机制.方法 选择健康新西兰大白兔30只,随机分为5组:正常对照组(n=6)和蛛网膜下腔出血模型组(1d、3d、7d和14d,n=6):建立兔二次蛛网膜下腔出血后脑血管痉挛实验模型,脑血管造影分析基底动脉的直径变化并应用Western Blot检测基底动脉Cx43蛋白的表达变化.对血管直径与Cx43表达变化情况进行相关分析.结果 成功建立兔二次蛛网膜下腔出血模型;脑血管造影显示注血后1d基底动脉即出现痉挛(85.7%±8.6%,P<0.05);7d时达高峰(66.5%±7.6%,P<0.01);14d时仍有痉挛(78.4%±8.2%,P<0.05)但程度较前缓解.Cx43蛋白表达在建立SAH模型后1d(38.6%±5.6%,P<0.05)、3d(50.2%±5.7%,P<0.05)、7d(57.8%±5.3%,P<0.01)、14d(32.4%±3.6%.P<00.05)均升高,其中7d为高峰,14d开始下降.Cx43蛋白表达的时相性变化与SAH后基底动脉直径的时相性变化相关系数为0.914.结论 实验结果 显示蛛网膜下腔出血后兔基底动脉缝隙连接蛋白Cx43的表达发生了时相性变化,并且Cx43蛋白表达强弱与蛛网膜下腔出血后脑血管痉挛程度在时程上存在正相关关系,表明缝隙连接蛋白Cx43可能参与蛛网膜下腔出血后脑血管痉挛的形成.

Abstract：

Objective The study was designed to explore the change of expression of connexin43(Cx43)protien in the model of subarachnoid hemorrhage(SAH)of rabbits,hoping to provide the basis to study the mechanism of cerebral vasospasm(CVS).Methods 30 New Zealand rabbits were divided into 5 groups:SAH group(1d,3d,7d,14d,n=6)and control group(n=6).The model of CVS following SAH was established.Digital subtraction angiography was performed to detect the change of the basilar arteries diameter.The expression of Cx43 protien in basilar arteries tissue at different time points following experimental SAH was examined by using western blotting analysis.The data were statistically analyzed using the bivariate correlations test.Results The model of SAH in rabbits was successfully established.All 30 rabbits were analyzed.Cerebral angiograms on 1d,3d,7d and 14d showed severe narrowing of the BAs,and on 7d showed the most narrowing and on 14d began to Relieve.Western blotting showed that the expression of Cx43 protein were detected in normal rabbit basilar arteries tissue.However,the expression of Cx43 protein increased gradually and significantly in models compared with that of control(P<0.05),which reached peak on 7d(P<0.01)and then decreased on 14d(P<0.05).There was positive correlation between expression of Cx43 and cerebral vasospasm.Conclusions The above results demonstrates at the first time that the Cx43 protein expression is altered after the SAH,and exhibits a time-dependent change.which might be connected with the development of CVS.In summary,our data demonstrates gap junctions may play an important role in the pathogenesis of cerebral vasospasm after SAH.     

黄芪甲苷对大鼠蛛网膜下腔出血后脑血管痉挛的影响

目的 探讨黄芪甲苷对大鼠蛛网膜下腔出血（SAH）后脑血管痉挛（CVS）的作用。方法 将成年雄性SD大鼠40只随机分为正常组、SAH组、二甲基亚砜组（DMSO,腹腔注射等体积0.1% DMSO）和黄芪甲苷组（腹腔注射用0.1% DMSO助溶的黄芪甲苷溶悬液,2 mg/ml）,每组10只。采用血管内刺破法制作SAH模型。HE染色观察基底动脉形态改变;免疫组化染色分析基底动脉Toll样受体4（TLR4）、核转录因子kappa B（NF-κB）的表达。结果 与正常组相比,SAH组和DMSO组基底动脉管壁明显增厚（P<0.05）,而管腔横截面积明显缩小（P<0.05）;SAH组和DMSO组无明显差异（P>0.05）。黄芪甲苷组基底动脉管壁厚度较DMSO组明显变薄（P<0.05）,管腔横截面积较DMSO组明显增大（P<0.05）。与正常组相比,SAH组和DMSO组基底动脉TLR4、NF-κB阳性率明显增高（P<0.05）,而SAH组和DMSO组无明显差异（P>0.05）。黄芪甲苷组基底动脉TLR4、NF-κB阳性率较DMSO组明显下降（P<0.05）。结论 黄芪甲苷可能通过干预TLR4、NF-κB介导的炎症信号通路来缓解大鼠SAH后CVS。     

17β-雌二醇对大鼠蛛网膜下腔出血后脑血管痉挛的影响及其机制

目的探讨17β-雌二醇（E₂）对蛛网膜下腔出血（SAH）引发的脑血管痉挛（CVS）的影响及其机制。方法雄性Wistar大鼠70只按随机数字表分为SAH组、SAH+E₂组、SAH+安慰剂组、空白组。采用枕大池二次注血法制作SAH模型。CVS的程度以第一次注血后7d的基底动脉平均横截面积评估。酶联免疫吸附法检测血清内皮型一氧化氮合酶（eNOS）及诱导型一氧化氮合酶（iNOS）水平。原位细胞凋亡检测法检测颞叶神经元凋亡情况。结果与SAH组及SAH+安慰剂组相比,SAH+E₂组大鼠基底动脉横截面积明显增加,血清iNOS浓度明显降低,eNOS浓度明显升高,皮质神经元凋亡指数显著降低（P<0.01）。结论 E₂可有效缓解大鼠SAH后的CVS,并具有脑保护作用,其机制可能与E₂维持SAH后血管内皮功能的稳定有关。     

促红细胞生成素缓解蛛网膜下腔出血后脑血管痉挛的实验研究

目的 研究早期全身使用促红细胞生成素(EPO)对蛛网膜下腔出血(SAH)后脑血管痉挛(CVS)的作用并探索其作用机理. 方法 将30只雄性新西兰白兔按照随机数字表法等分为5组:(1)空白组;(2)对照组;(3)SAH组;(4)SAH+安慰剂组;(5)SAH+重组人促红细胞生成素(rHuEPO)组.后三组采用枕大池注血法建立兔SAH模型.注血后48 h采用灌注同定法处死动物,留取基底动脉标本.通过测定基底动脉血管横截面积判断有无CVS,并用原位细胞凋亡检测法(TUNEL)检测血管内皮细胞凋亡情况. 结果 基底动脉横截面积测定的结果 提示空白组和对照组、SAH组和SAH+安慰剂组比较,差异无统计学意义(p>0.05);SAH组和SAH+安慰剂组较空白组和对照组明显缩小,差异有统计学意义(P<0.05)SAH+rHuEPO组较SAH组和SAH+安慰剂组明显增大,差异有统计学意义(P<0.05).但小于空白组和对照组.TUNEL染色显示SAH+rHuEPO组血管内皮细胞凋亡程度较SAH组和SAH+安慰剂组减轻,差异有统计学意义(P<0.05). 结论 早期全身使用rHuEPO能减少兔SAH模型基底动脉血管内皮细胞凋亡并部分缓解CVS.     

大鼠蛛网膜下腔出血后基底动脉病理结构的变化

目的观察大鼠蛛网膜下腔出血(SAH)后基底动脉病理结构的变化。方法采用枕大池二次注血的方法建立SAH大鼠模型,对照组同法注等量的生理盐水。观察两组大鼠基底动脉血管腔内周长、血管壁厚及其超微结构的改变。结果对照组大鼠基底动脉腔内周长、血管壁厚及其超微结构正常,SAH组大鼠血管腔内周长明显缩短,血管壁增厚,内皮细胞变性、内弹力膜增生变性、平滑肌细胞变性。结论大鼠SAH后脑血管痉挛的病理基础是血管内皮细胞通透性增高,内弹力膜增厚,平滑肌细胞变性。