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目的探讨孕酮(progesterone,PG)对大鼠蛛网膜下腔出血(subarachnoid hemorrhage,SAH)后早期脑损伤(early brain injury,EBI)的保护作用及其机制。方法健康雄性SD大鼠48只按随机数字表法分为假手术组(Sham组)、蛛网膜下腔出血组(SAH组)和孕酮组(PG组)。采用枕大池自体血注入法建立蛛网膜下腔出血模型。各组于处理后48 h经苏木素-伊红染色观察海马神经元的组织形态学变化。应用原位末端标记法(TUNEL)检测海马神经元凋亡。运用免疫组织化学法检测大鼠海马中抗凋亡蛋白Bcl-2和促凋亡蛋白Bax的表达。结果与SAH组相比,PG组海马凋亡细胞数显著减少(P<0.05),Bcl-2表达升高(P<0.05),Bax表达下降(P<0.05)。结论孕酮可能通过促进Bcl-2的表达和降低Bax的表达(即提高Bcl-2/Bax比值),而抑制海马神经元的凋亡,对蛛网膜下腔出血后早期脑损伤发挥保护作用。
Objective To investigate the protective effect of progesterone (PG) on early brain injury (EBI) after subarachnoid hemorrhage (SAH) in rats and its mechanism. Methods Forty - eight healthy male Sprague - Dawley rats were randomly divided into Sham group, SAH group and progesterone group (PG group) according to random number table. Subacute subarachnoid hemorrhage model was established by autologous blood injection in occipital cistern. The histopathological changes of hippocampal neurons were observed by hematoxylin-eosin staining 48 h after treatment. Hippocampal neuronal apoptosis was detected by TUNEL. Immunohistochemistry was used to detect the expression of anti-apoptotic protein Bcl-2 and pro-apoptotic protein Bax in rat hippocampus. Results Compared with SAH group, the apoptotic cells in hippocampus of PG group were significantly decreased (P <0.05), the expression of Bcl-2 was increased (P <0.05) and the expression of Bax was decreased (P <0.05). Conclusions Progesterone can inhibit the apoptosis of hippocampal neurons by promoting the expression of Bcl-2 and decreasing the expression of Bax (that is, increasing the ratio of Bcl-2 / Bax), and plays a protective role in early brain injury after subarachnoid hemorrhage.