人大脑及脑干挫伤后星形胶质细胞及其胶质纤维酸性蛋白的变化

目的探讨人大脑及脑干挫伤后星形胶质细胞(Ast)及其特殊标记物胶质纤维酸性蛋白(GFAP)变化与损伤时间的关系,以及大脑与脑干挫伤后病变的差异。方法对87例闭合性颅脑损伤死亡者脑挫伤组织进行病理学及GFAP免疫组织化学检查。结果脑挫伤后Ast灶性肥大及增生最早见于伤后12h,7～14d达高峰,30d胶质瘢痕基本形成。在Ast4项图像分析指标中,平均细胞数在伤后首先下降然后逐渐增加,细胞平均吸光度值、积分吸光度值及细胞平均面积在脑挫伤后14d内随时间延长而逐渐增加,大脑与脑干之间Ast的上述4项指标在脑挫伤后均呈正相关关系,相关性由高至低为:平均细胞数>平均吸光度值>积分吸光度值>细胞平均面积。结论星形胶质细胞GFAP免疫组织化学检查结合图像分析技术可用于脑挫伤后经过时间的推断,大脑与脑干挫伤后星形胶质细胞GFAP变化趋势基本一致。

Changes of Astrocytes and GFAP after Human Cerebra and Brain Stem Contusion

Objective To study the relationships between the changes of astrocytes and glial fibrillary acidic protein (GFAP) with the injury time after human cerebra and brain stem contusion and the the difference of pathological changes between cerebra and brain stem contusion.Methods Eighty-seven cases of brain contusions of the closed head injury were subjected to the examinations of pathology and immunohistochemistry for GFAP.Results The hypertrophy and hyperplasia of astrocytes appeared as early as 12 h after injury and reached the peak between 7-14 days. In general, glial scar was formed at 30th day. For the 4 indexes of image analysis of astrocytes, average cell number (CN) was decreased firstly, then gradually increased; average A value, integral A value and average area of cells were increased gradually during 14 days of the brain injury. The 4 indexes of astrocytes had a positive correlation between the contusion of cerebra and that of brain stem. The correlation of the 4 indexes was CN>average A value>integral A value>average area of cells from high to low.Conclusion GFAP immunohistochemical stain and image analysis technique could be used to estimate post-injury interval of the brain contusion. The changes of astrocytes and GFAP after cerebra contusion are similar to those of brain stem contusion.