摘要
目的研究高血压脑出血患者血肿周围脑组织缺氧诱导因子-1a(Hypoxia inducible factor 1,HIF-1a)的表达与脑水肿形成的关系。方法选择行高血压性脑内血肿清除术治疗的脑出血患者32例,选取手术过程中获得的血肿周围脑组织,采用免疫组织化学技术测定缺氧诱导因子- 1a及血管内皮生长因子(vascular endothelial growth factor,VEGF)的表达。根据头颅CT测量血肿周围脑水肿带的大小,用双盲法对染色结果及脑水肿的体积进行分析。结果出血4 h后,血肿周围脑组织即可见散在HIF-1a表达的神经元[(2.8±0.8)个/高倍视野],24～48 h时达到高峰[(12.5±3.9)个/高倍视野],48～72 h高表达持续存在[(12.2±1.8)个/高倍视野];HIF-1a的表达与VEGF(r=0.76,t=6.37,P<0.01)、脑水肿体积(r=0.64,t=4.56,P<0.01)成正相关性。结论高血压脑出血血肿周围组织HIF-1a的表达与脑水肿的形成有关,HIF-1a可能通过诱导、调控VEGF的表达促进脑水肿的形成。
Objective To investigate the correlation between the expression of HIF-1a （hypoxia inducible factor 1, HIF-1a） in perihematomal brain issue and formation of brain edema in patients with hypertensive cerebral hemon＇hage. Method Perihematomal brain issue was collected in the course of hematoma elimination in 32 patients with hypertensive intracerebral hemorrhage. Expressions of HIF-1a and vascular endothelial growth factor （VEGF） were observed by immunohistochemistry. The volume of perihematomal brain edema on computed tomographic scan was determined by computed tomographic scan before surgery. The results of staining and the volume of perihematomal brain edema were analyzed in double blind fashion. Results HIF-1a protein immunohistochemical staining positive cells （2.8 ± 0.8/HP） were identified dispersedly from 4 hours after acute hemorrhagic stroke in perihematomal brain issue, and reached the peak at 24 - 48 hours （12.5 ± 3.9/HP）. High expression of HIF-1a progressed at 48 - 72 hours （ 12.2 ±1.8/HP） after acute hemorrhagic stroke. There was a positive correlation between the expression of HIF-1a and VEGF （ r = 0.76, t = 6.37, P 〈 0.01）, brain edema （r=0.64, t =4.56, P〈0.01）. Conclusions＇ There was a significant correlation between the expression of HIF-1a and formation of perihematomal brain edema. HIF-1a may accelerate formation of perihematomal brain edema by regulating and inducing expression of VEGF.
出处
《中华急诊医学杂志》
CAS
CSCD
2007年第9期921-924,共4页
Chinese Journal of Emergency Medicine
