摘要
目的:探讨实验性脑出血微创抽吸术联合腹腔、血肿腔应用单唾液酸四己糖神经节苷脂(GM1)对脑出血急性期神经功能的影响。方法:将Ⅳ型胶原酶注入SD大鼠尾状核诱导形成脑出血10h后,向血肿腔内注入尿激酶溶解血凝块,实施微创血肿抽吸术排出脑内血肿,通过对抽吸组、抽吸腹腔给药组、抽吸血肿腔给药组之间不同时间脑组织caspase-3,GFAP免疫组化检测,大鼠神经功能缺损评分,对微创抽吸术联合2种途径应用GM1的神经功能影响进行评估。结果:血肿腔、腹腔给药组同抽吸组比较,3d(P<0.05)、5d、7d的caspase-3,GFAP阳性细胞数及蛋白表达量明显减少,尤其是5d、7d的减少更显著(P<0.01)。血肿腔给药组和腹腔给药组比较,前者3d(P<0.05)、5d、7d的caspase-3,GFAP阳性细胞数及蛋白表达量明显减少,尤其是5d、7d的减少更明显(P<0.01)。血肿腔、腹腔给药组同抽吸组比较,3d(P<0.05)、5d、7d的神经功能恢复较显著,尤其是5d和7d神经功能恢复更显著(P<0.01);血肿腔给药组和腹腔给药组比较,前者的3d(P<0.05)、5d、7d神经功能恢复显著,5d、7d差异更显著(P<0.01)。结论:脑出血神经功能缺损可能与细胞凋亡和反应性星形胶质细胞增生有关。单唾液酸四己糖神经节苷脂有抑制脑出血细胞凋亡和反应性星形胶质细胞增生作用。脑出血立体定向血肿抽吸联用单唾液酸四己糖神经节苷脂局部血肿腔给药是实验性脑出血脑保护作用更经济、有效的治疗方案。
OBJECTIVE To discuss the effect of minimally invasive hematoma aspiration combining with the administration of monosialoganglioside（GM1 ）injected into peritoneal and hematoma intracavity on nervous function of acute stage originated by intracerebral hemorrhage. METHODS Intracerebral hemorrhage was induced by injecting IV collagenase into caudate nucleus of SD rats, and after ten hours urokinase was injected into hematoma intracavity to dissolve clot. Hematoma was removed from intracavity by use of minimally invasive hematoma aspiration. The effect of minimally invasive hematoma aspiration combining with the administration of monosialoganglioside （GM1） on nervous function was evaluated by determination of defect of the nervous function and immunohistochemistry of caspase-3, GFAP in brain tissue during different time , among aspiration group, aspiration combining with GM1 peritoneal injection group and aspiration combining with GM1 hematoma cavity injection. RESULTS Positive cells and protein express of caspase-3, GFAP of hematoma cavity group,abdominal cavity group were significantly decreased compared with aspiration group at 3 d （P〈0. 05） ,5 d,7 d, especially at 5 d,7 d （P〈0. 01）. Hematoma cavity group and abdominal cavity group were compared, positive cells and protein express of caspase-3, GFAP of the former were significantly decreased at 3 d（P〈0. 05）, 5 d, 7 d, especially at 5 d, 7 d （P〈0. 01 ） ; Neurologic functional recovery of hematoma cavity group,abdominal cavity group was more significant compared with aspiration group at 3 d（P〈0. 05） ,5 d,7 d, especially at 5 d,7 d （P〈0. 01）. Hematoma cavity group and abdominal cavity group were compared, neurologic functional recovery of the former was significantly better significant at 3 d（P〈0. 05） ,5 d,7 d, especially at 5 d,7 d （P〈0. 01）. CONCLUSION Defect of the nervous function of ICH possibly relates apoptosis and accrementition of horizontal cell. GM1 has effect of suppress- ing apoptosis and accrementition of horizontal cell, which possibly is one of the mechanisms of promoting neurologic functional recovery. Medication dosage of minimal invasive hematoma aspiration combining with GM1 hematoma cavity injection was effective and more economical in the treatment of intra-cerebral hemorrhage.
出处
《中国医院药学杂志》
CAS
CSCD
北大核心
2010年第10期834-837,共4页
Chinese Journal of Hospital Pharmacy
