高血压脑出血患者血肿周围脑组织细胞凋亡与Caspase-3表达规律的临床研究

目的初步探讨高血压脑出血患者血肿周围脑组织细胞凋亡的病理变化规律及其与Caspase-3的关系。方法术中获取19例不同时段脑出血患者血肿灶周围脑组织标本作为病例组,手术入路中远隔血肿部位脑组织标本5例作为对照组。根据脑出血后时间的不同将病例组分为:超早期组(<8h);早期组(8～24h);延期组(> 24h)。所有标本均行TUNEL染色以及Caspase-3免疫组化染色,利用图像分析仪观察阳性细胞数的变化规律,分析凋亡细胞与Caspase-3阳性细胞之间的关系。结果血肿周围脑组织存在TUNEL阳性细胞表达,出血后8～24h达高峰,随后下降,并且与Caspase-3的变化趋势相一致。结论细胞调亡是高血压脑出血患者血肿周围早期细胞死亡的主要形式。做为细胞凋亡的重要调控因子,Caspase-3的表达与脑出血后细胞凋亡的发生发展密切相关。

The change of apoptosis happened in perihematoma region among hypertensive intracerebral hemorrhage patents and its relations with the expression of Caspase-3 protein

Objective To investigate the change of apoptosis in perihematoma region among hypertensive in-tracerebral hemorrhage (HICH) patients and its relation with the expressions of Caspase-3 protein. Methods 19 samples were obtained from the perihematoma region of HICH patients and divided into 3 groups according to the time from onset to operation:super-early phase(<8h) ;early phase (8-24h) and delayed phase(>24h). 5 samples were obtained from distant regions as the normal control group. The terminal deoxynucleotidyl transferase-mediat-ed deoxyuridine 5-triphosphate nick-end labeling(TUNEL)method was used to detect apoptosis,and the expression of Caspase-3 was observed by immunohistochemistry. Quantification of positive cells was performed by the image analyzer. Results TUNEL positive cells appeared in the perihematoma region of HICH patents before 8h,peaking during the time of 8~24h after onset and declining thereafter. The expression of Caspase-3 protein was consistent with the apoptosis. Conclusion Apoptosis represents a prominent form of cell death associated with HICH in the perihematoma region. Caspase-3,the important mediator of apoptosis,has an intimate relation with the brain tissue apoptosis induced by the hematoma.