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目的 探讨脑血管痉挛 (CVS)与免疫炎症反应的关系。方法 采用Willis环二次注血的方法制备家兔蛛网膜下腔出血 (SAH)模型 ,通过光镜和电镜检查动态观察痉挛血管壁的病理变化 ,根据DSA上测定基底动脉(BA)直径来评价CVS ,用免疫组化方法测定痉挛血管壁IgG的沉积。 结果 SAH后痉挛血管壁明显增厚并伴有炎症细胞的浸润 ,细胞内超微结构也有明显改变 ,其变化程度与CVS密切相关。SAH后 3d时痉挛血管壁有轻至中度的IgG沉积 ,7d时全为中度沉积 ,14d时 1例有IgG沉积。 结论 SAH后血管壁发生了器质性病理变化 ,且具有炎症反应的特征 ,CVS的时相及程度与痉挛血管壁IgG的沉积密切相关 ,提示免疫炎症反应参与了CVS的发病机制。
Objective To investigate the relationship between cerebrovascular spasm (CVS) and immune inflammation. Methods Rabbit subarachnoid hemorrhage (SAH) model was prepared by Willis ring second injection method. The pathological changes of the spasm vessel wall were observed by light and electron microscopy. The diameter of basilar artery (BA) was determined by DSA CVS was used to determine the deposition of IgG in spasmodic wall by immunohistochemistry. Results After SAH, the vascular wall of thymus was obviously thickened and infiltrated with inflammatory cells. The intracellular ultrastructure also changed obviously. The degree of change was closely related to CVS. There was mild to moderate IgG deposition on the wall of spastic blood vessel after 3d in SAH, moderate deposition on 7d, and IgG deposition on the 14th day. Conclusions The pathological changes of blood vessel wall after SAH are characterized by inflammatory reaction. The phase and degree of CVS are closely related to the deposition of IgG on the wall of spastic blood vessel, suggesting that the immune inflammatory reaction is involved in the pathogenesis of CVS.