脑挫裂伤后细胞凋亡及其相关基因的研究

目的 探讨脑挫裂伤患者的细胞凋亡及其相关基因的表达。方法 31例脑挫裂伤患者因颅内占位效应而行开颅减压术，术中切除部分脑组织，其中10例脑挫裂伤周围非坏死组织检测到细胞凋亡。TUNEL法检测细胞凋亡，免疫组化法检测细胞凋亡相关基因p53、bcl-2与bax的表达。结果 全部患者均表达bax，6例表达bcl-2，8例患者检测到TUNEL阳性细胞，1例p53阳性，bcl-2表达阳性患者预后好于bcl-2阴性患者。结论 脑挫裂伤患者主要的病理改变为坏死，然而细胞凋亡可以造成继发的脑损害。bcl-2表达阳性的患者预后更佳。促进bcl-2表达或抑制bax表达来预防细胞凋亡具有重要的临床意义。

Study of apoptosis and related gene after cerebral contusions in humans

Objective To study the apoptosis and related gene after cerebral contusions.Methods Thirty-one specimens of brain tissue excised during emergency craniotomy for cerebral contusions with mass effect were examined.These were examined for the presence of apoptosis cells by the TUNEL method as well as by immunohistochemistry to detect possible expression of the apoptosis-related gene p53,bcl-2,and bax.Result Bax expression was detected in all the patients,whereas bcl-2 expression was noted in six patients.TUNEL positive cells were noted in eight patients,p53 positive immunostaining was observed in one case.Patients with bcl-2expression had a better survival rate than those without bcl-2expression .Conclusion Necrosis seemed to be the main findings in cerebral contusions,but apoptosis may contribute to the secondary injury processes.Patients with bcl-2 have a better prognosis.This may have important clinical significance by developing bcl-2 or bax inhibitors to prevent apoptosis.