Eriksen Nina, Rasmussen Rune S, Overgaard Karsten, Johansen Flemming F, Pakkenberg Bente
Research Laboratory for Stereology and Neuroscience, Bispebjerg Hospital, University Hospital of Copenhagen, Copenhagen, Denmark.
Int J Stroke. 2014 Aug;9(6):802-10. doi: 10.1111/j.1747-4949.2012.00870.x. Epub 2012 Aug 29.
Strokes have both ischemic and hemorrhagic components, but most studies of experimental stroke only address the ischemic component. This is likely because investigations of hemorrhagic transformation are hindered by the lack of methods based on unbiased principles for volume estimation.
We evaluated different methods for estimating the volume of infarcts, hemorrhages, after embolic middle cerebral artery occlusion with or without thrombolysis.
An experimental thromboembolytic rat model was used in this study. The rats underwent surgery and were placed in two groups. Group 1 was treated with saline, and group 2 was treated with 20 mg/kg recombinant tissue plasminogen activator to promote intracerebral hemorrhages. Stereology, semiautomated computer estimation, and manual erythrocyte counting were used to test the precision and efficiency of determining the size of the infarct and intracerebral hemorrhage.
No differences were observed in the infarct volume or amount of bleeding when comparing the three methods of volume estimation. Although semiautomated computer estimation and manual erythrocyte counting provided similar results as the stereological measurements, the stereological method was the most efficient and advantageous.
We found that stereology was the superior method for quantification of hemorrhagic volume, especially for rodent petechial bleeding, which is otherwise difficult to measure. Our results suggest the possibility of measuring both the ischemic and the hemorrhagic components of stroke, two parameters that may be differentially regulated when therapeutic regimens are tested.
中风既有缺血性成分，也有出血性成分，但大多数实验性中风研究仅涉及缺血性成分。这可能是因为缺乏基于无偏倚原则的体积估计方法阻碍了对出血转化的研究。
我们评估了在有或没有溶栓的情况下，栓塞大脑中动脉闭塞后估计梗死灶、出血灶体积的不同方法。
本研究使用了实验性血栓栓塞大鼠模型。大鼠接受手术并分为两组。第1组用生理盐水治疗，第2组用20mg/kg重组组织型纤溶酶原激活剂治疗以促进脑出血。使用体视学、半自动计算机估计和手动红细胞计数来测试确定梗死灶和脑出血大小的精度和效率。
比较三种体积估计方法时，梗死灶体积或出血量未观察到差异。虽然半自动计算机估计和手动红细胞计数提供了与体视学测量相似的结果，但体视学方法是最有效和最具优势的。
我们发现体视学是量化出血体积的 superior 方法，特别是对于啮齿动物的瘀点出血，否则很难测量。我们的结果表明有可能测量中风的缺血性和出血性成分，这两个参数在测试治疗方案时可能受到不同的调节。
