脑出血后的病理改变与T淋巴细胞反应

目的:探讨脑出血血肿周围局部病理改变及细胞免疫机制。方法:用免疫组化方法及组织HE染色法观察20只大鼠尾壳核脑出血24 h,3天、7天血肿周围区域的组织病变及CD3 、CD8 T淋巴细胞的分布形式和表达时程。结果:①在脑出血后24 h血肿周围即可见明显血管源性水肿,大量炎性细胞浸润,以中性粒细胞为主,少量散在淋巴细胞、小胶质细胞、星形细胞、少突胶质细胞弥漫浸润;出血3天、7天以淋巴细胞、巨噬细胞浸润为主,小胶质细胞、星形细胞、少突胶质细胞增生明显,双侧半球皮层下和血管周围出现小胶质细胞结节;②出血灶周围CD3 和CD8 T淋巴细胞浸润在出血后24 h已可见,出血后3天组和出血后7天组,CD3 和CD8 阳性细胞数明显高于出血后24 h组。结论:①脑出血期以中性粒细胞反应为主,以后以淋巴细胞反应为主,胶质细胞反应在出血后24 h已发生,持续一周以上;②CD3 、CD8 阳性细胞的出现提示它们参与了出血后脑损伤的病理过程,在出血7天内, CD3 和CD8-阳性细胞反应呈增强趋势。

The pathologic changes and T-lymphocyte reactions after cerebral hemorrhage in rats

Objective: To explore pathological Changes of cell immunity mechanism of hematoma surrounding tissues after acute cerebral hemorrhage in rats. Methods: By staining methods of immuno-chemisty and pathology , to investigate the pathological changes and CD3 or CD8 lymphocytes expression and distribution in hematoma surrounding tissues at the 24th hour ,3rd and 7th day after hemorrhage of chilincaudal nucleus in rats. Results: At the 24th hour after cerebral hemorrhage, a large number of inflammatory cells infiltration and cerebral edema appeared. On the 3rd and 7th day , a large number of lymphocytes and macrophago cytes appeared. At the 24th hour after hemorrhage , the CD3 and CD8 T lymphocytes were shown. But the number of positive cells increased on the 3rd and 7th day in comparison with those at the 24th hour after hemorrhage . Conclusions: In the early stage of hemorrhage, the neutrophil infiltration is a main inflammatory process, but the positive lymphacytes and macrphages infiltration are severe on the 3rd and 7th day. The CD3 and CD8 positive cells have participated in the pathological process after cerebral hemorrhage.