摘要
目的 观察弥漫性轴突损伤的常见部位， 病理改变过程， 以及其发生原因和机制。探讨其与临床的相关性。方法 用 Ｍａｒｍａｒｏｕ 的落体打击装置致伤动物， 大鼠脑组织标本在光镜和电镜下观察。结果 轴突回缩球密度在桥脑基底部和小脑上脚最高。伤后轴突内的微丝、微管结构紊乱， 轴突肿胀。伤后３ 天， 多数肿胀的轴突断裂， 形成轴突回缩球。１ 小时组轴突内钙颗粒数量是对照组的１７ 倍， 提示钙的内流。结论 本实验中弥漫性轴突损伤的最常见部位是桥脑基底部和小脑上脚。轴突损伤的过程为： 轴突内结构的紊乱， 轴突肿胀及断裂。轴突损伤的主要发生原因和机制可能是细胞外钙的内流。在伤后１２ 小时以内， 损伤轴突尚未断裂， 可能仍存在可逆性， 这可能是临床上有效治疗的最佳时机。
Objective To observe the common site of diffuse axonal injury(DAI)and the progress of its pathological changes, and its pathogenesis and mechanism, finally, to find out its clinical correlation. Methods The head injured animal model was impacted by an weight drop device designed by Marmarou. The samples of each rat brain were taken to do the HE and Bielschowsky stain and were examined under light microscopy or transmission electron microscopy.Results The density of retraction ball (RB) in the basal portion of the pons and superior cerebellar peduncle was the highest. After head injury, the microfilaments and microtubules of the injured axons became misaligned, and swelled. By 3 days, most swollen axons were divided, thus the RB were formed.The number of intraaxonal calcium particles in 1 hour group was 1 7times than that in control group, suggesting the inflow of calcium. Conclusion Our study suggest that the most common site of DAI in this experiment was the basal portion of the pons and superior cerebellar peduncle. The process of the pathological changes of DAI were: misalignment of the intraaxonal structures, axonal swelling and transsection. The inflow of normally extracellular calcium might be the main pathogenesis and mechanism of axonal injury .Within 12 hours after injury, the injured axons were not yet devided,and its reversibility might still remain. This might be the most ideal time for effective treatment.
出处
《中华神经外科杂志》
CSCD
北大核心
1999年第5期285-287,共3页
Chinese Journal of Neurosurgery
基金
国家自然科学基金
