【作者】 彭绍鹏；

【导师】 任海军；

【作者基本信息】 兰州大学 ， 外科学， 2010， 硕士

【摘要】 目的探讨高血压脑出血(HICH)早期血肿周围脑组织细胞凋亡与凝血酶表达的关系。方法取36例高血压脑出血患者血肿周围脑组织作为实验组,按发病至手术的时间分为5组：<6h(7例)、6～12 h(11例)、12～24 h(8例)、24～48h(6例)、48～72 h(4例)。另将侧脑室肿瘤患者经皮层入路取得的正常脑组织作为对照组。采用脱氧核糖核苷酸末端转移酶介导的缺口末端标记法(TUNEL)检测神经细胞凋亡率,免疫组织化学方法检测凝血酶表达。结果对照组脑组织基本无TUNEL阳性细胞(0.32±0.037)；<6 h组有轻微表达(7.19±2.53,P<0.05),发病6h后逐渐增高(15.11±3.69,P<0.01),12～24h增高显著(28.26±7.83,P<0.01)并于24～48 h达高峰(53.79±6.35,P<0.01),48～72h组有所回落,但仍维持较高水平(38.23±3.29,P<0.01)。凝血酶表达变化与此一致。相关分析显示：细胞凋亡与凝血酶表达呈显著正相关(r=0.7451,P<0.05或P<0.01)。结论HICH患者血肿周围脑组织中存在细胞凋亡,凝血酶表达是细胞凋亡过程中的一个关键事件更多还原

【Abstract】 Objective To investigate the relationship between cell apoptosis and expression of thrombin in the perihematoma tissue in early hypertensive intracerebral hemorrhage (HICH).Methods 36 samples were obtained from the perihematoma region of HICH patients and divided into 5 groups according to the time from onset to operation:6hours (n=7),6～12hours (n=11),12～24hours (n=8),24～48hours (n=6),48～72hours (n=4). The normal control group were collected from the patients with lateral ventricle tumor who were operation by transcortical approach.The terminal deoxynucleotidyl-transferase mediated dUTP-biotin nick end labeling (TUNEL) method was used to detect apoptosis and the expression of thrombin was observed by immunohistochemistry.Results the TUNEL positive cells was almost no expression in the control group (0.32±0.037) and it have a slight expression in<6 h group(7.19±2.53,P< 0.05).It increased gradually 6hours after the onset of HICH (15.11±3.69, P< 0.01)and reached the maximum at 24～48 hours (53.79±6.35, P< 0.01).48-72h group has dropped slightly, but still maintain a high level (38.23±3.29, P<0.01). The expression of the thrombin was consistent with the apoptosis. The correlation analysis showed that the TUNEL positive cells was positively correlated to the expression of the thrombin (P<0.05 or P<0.01).Conclusion Apoptosis cells exist in perihematomal region among hypertensive intracerebral hemorrhage.The expression of thrombin is a critical step in apoptotic cell death after hypertensive intracerebral hemorrhage.更多还原