微创颅内血肿清除治疗对兔脑内血肿周围组织的保护作用与Bcl-2、Bax表达变化的关系

目的探讨兔脑内血肿周围组织中Bcl-2、Bax表达及微创血肿清除治疗对其表达变化的影响,探讨微创血肿清除治疗脑保护作用机制.方法采用新鲜未肝素化自体血2次注血法制作脑出血模型,部分脑出血模型用尿激酶在兔脑内血肿局部溶解血肿,血肿形成 6h内抽吸血肿,运用原位杂交技术动态观察脑出血后Bcl-2 、Bax基因表达的变化,以及微创颅内血肿清除治疗对它们的影响.结果两组血肿周围脑组织Bcl-2 mRNA表达都在6h达高峰,以后随时间延长逐渐下降.治疗组较对照组Bcl-2 mRNA表达明显增强;两组比较均有显著性差异(P<0.05).两组Bax mRNA表达高峰在24h,然后逐渐减弱.治疗组较对照组Bax mRNA表达明显减弱;两组比较均有显著性差异(P<0.05).结论微创血肿清除治疗明显增强血肿周围脑组织Bcl-2 mRNA的表达、抑制Bax mRNA的表达,发挥抗凋亡和/或抗坏死作用,减轻脑出血继发性损害.

The relationship between the protection of minimally invasive hematoma evacuation method and expression of Bcl-2 and Bax in perihematomal brain regions of rabbits

Objective To investigate the expression of Bcl-2 and Bax in perihematomal brain regions of rabbits and the influence of minimally invasive hematoma evacuation methods on them and to probe the possible protective mechanisms of minimally invasive hematoma evacuation methods.Methods Fresh unclotted autologous blood was injected into rabbit's right ganglia.The animal were divided into two groups.One of two groups was injected blood on single side to observe the pathological change of ICH in rabbits.Another group was treated by hematoma evacuation methods in 6h after the same model of intracerebral hemorrhage was made.H-E staining and Situ Hybtidization Histo -cytochemistry (ISHH) reactions of Bcl-2 and Bax was carried out correspondingly.Results The expression of Bcl-2 mRNA in the brain tissue around hematoma in both groups amounted to the peak at 6h,then decreased gradually.The expression of Bcl-2 mRNA of TG group was stronger than that of control group.There was a markly differenc between two groups in 1,3,7d(P<0.05);the expression of Bax mRNA of two groups amounted to the peak at 24h,then decreased gradually.The expression of Bax mRNA of TG group was weaker than that of control group.There were markedly differences between the two groups at 1d,3d and 7d(P<0.05).Conclutions Minimally invasive clot aspiration after lysis with urokinase could apparently enhance the expression of Bcl-2 mRNA in the brain tissue around hematoma and prevent expression of Bax mRNA,which would exert its influence to inhibit apoptosis or necrosis,palliate hemorrhagic injury of brain.