兔脑损伤后CKMB表达及其意义.docVIP

PAGE PAGE 7 兔脑损伤后CK－MB的表达及其意义 马东周 李和平 刘献军 孙红燕 王红斌 朱庆华 邵连彬 冀志武 ［摘要］ 目的 观察兔脑损伤后肌酸激酶同工酶(CK-MB)表达的改变及其意义。方法 取成年灰色家兔采用自由落体法制成兔脑损伤动物模型，分别于伤后不同时段抽取动物静脉血和枕大池CSF，分析CK－MB的表达情况；而后将动物断头处死，取受伤区域脑组织进行脑组织含水量的测定；切片镜下观察组织的微观改变。结果 伤后6小时、24小时、72小时和168小时实验组动物血清及CSF中CK－MB明显高于对照组（P＜0.05或＜0.01）。实验组动物伤后3小时、6小时、24小时和72小时可见损伤区神经细胞水肿明显，微血管密度降低，微血管内微血栓形成，168小时水肿的神经细胞和微血管形态基本恢复正常。结论 脑损伤后血中CK－MB的表达上调，其表达和脑损伤相关联，提示CK－MB可能参与了脑水肿的调控过程，CK－MB测定可能成为判断病人脑损伤的程度和预后的方法。 ［关键词］ 脑损伤 肌酸激酶同工酶 脑水肿 微循环 兔 Expression and significance of CK-MB after cerebral injury in rabbit ［Abstract］ Objective To determine CK-MB after cerebral injury in rabbit and analyze the expression and significance of increased CK-MB in serum and CSF. Method Make cerebral injury rabbit model by falling body, determine CK-MB of serum and CSF, and analyze the expression and significance. Then the animals were killed, and the water of injured cerebral tissue was measured, and the cerebral injured tissue was observed by 作者单位：056002 邯郸 河北工程学院附属医院神经外科 microscopy. Results The CK-MB of serum and CSF is significant increase in 6, 24,72,168 hour after injury in experiment groups than in control group(P＜0.05 or＜0.01). There was edema of nerve cells, amount of micrangiums decreased, microthrombus in micrangium in 6, 24, 48 and 72 hour in experiment groups, but these changes were disappeared in 168 hour after injury. Conclusion High expression of CK-MB in serum and CSF after cerebral injury, the results suggest that cerebral edema may be regulated and controlled. Measurements of CK-MB in serum and CSF of patient with craniocerebral injuries may become a test for the laboratory diagnosis of the trauma severity and course. ［Key word］ Cerebral injury CK-MB Cerebral edema Microcirculation Rabbit 早在1968年Ramsey A等1研究发现，小鼠脑损伤后乳酸脱氢酶同工酶、谷氨酸脱氢酶、谷氨酸－丙氨酰转氨酶和肌酸磷酸激酶在外周血中的变化。肌酸激酶同工酶MB(creatine kinase isoenzyme, CK－MB)是心肌损害后较特征性表达的指标，但脑损伤后CK－MB在外周血中也有表达，临床工作人员对其认识较少；脑损伤后常常将其高表达误认为心肌损害并予以处理。脑损伤后CK－MB的表达和脑损伤的程度有何关系，我们对其进行了实验研究。 材料与方法 1. 动物的