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目的研究脑出血(intracerebral hemorrhage,ICH)后继发脑损伤的机制。方法雄性成年家犬12只,随机分为ICH组(n=6)和生理盐水对照组(n=6),ICH组于额叶注入非抗凝自体动脉血,对照组动物在相同部位注入等量生理盐水。在模型制备后2h、6h、24h、3d、7d、14d进行血肿周围脑组织间液微透析,监测葡萄糖、乳酸、丙酮酸、甘油和谷氨酸浓度。结果ICH组葡萄糖浓度无显著变化;乳酸浓度在注血后24h和3d升高;丙酮酸浓度在注血后6h、24h和3d升高;甘油浓度在注血后24h升高;谷氨酸浓度在注血后升高,3d达到高峰,至14d明显高于对照组和基础值。结论ICH后血肿周围脑组织代谢变化提示存在“生化半暗带”区域,兴奋性氨基酸的聚集可能是加重和维持继发性脑损伤的重要因素。
Objective To study the mechanism of secondary brain injury after intracerebral hemorrhage (ICH). Methods Twelve male domestic dogs were randomly divided into ICH group (n = 6) and saline control group (n = 6). ICH group was injected with non-anticoagulated autologous arterial blood in the frontal lobe, Normal saline. After 2h, 6h, 24h, 3d, 7d, 14d after model preparation, the intracerebral hematoma liquid microdialysis was performed and the concentrations of glucose, lactate, pyruvate, glycerol and glutamic acid were monitored. Results There was no significant change in glucose concentration in ICH group. The concentration of lactate increased 24 h and 3 d after injection. The concentration of pyruvate increased 6 h, 24 h and 3 d after injection. The concentration of glycerol increased 24 h after injection. After the injection of blood rose, 3d reached its peak, to 14d was significantly higher than the control group and the baseline value. Conclusion ICH changes of brain tissue around the hematoma suggest the presence of “biochemical dark zone”, the accumulation of excitatory amino acids may be an important factor in aggravating and maintaining secondary brain injury.