Wu Guofeng, Shi Jing, Wang Fan, Wang Likun, Feng Anrong, Ren Siying
Emergency Department of Affiliated Hospital, Guiyang Medical College, No, 28, Guiyijie Road, Liuguangmen, Guiyang City, Guizhou Province, 550004 PR China.
BMC Neurol. 2014 Apr 17;14:85. doi: 10.1186/1471-2377-14-85.
The effects of performing a minimally invasive procedure at different stages after intracerebral hemorrhage on perihematomal MMP-9 expression and blood-brain barrier (BBB) permeability were evaluated.
Sixty rabbits were randomly distributed into a model control group (MC group, 30 rabbits) or a minimally invasive group (MI group, 30 rabbits). A model of intracerebral hemorrhage was established in the MC and MI group. In the MI group, the intracerebral hematoma was evacuated by stereotactic minimally invasive procedures over 6 hours (6 rabbits), 12 hours (6 rabbits), 18 hours (6 rabbits) 24 hours or 48 hours (6 rabbits) following successful induction of intracerebral hemorrhage. The same procedure was performed in the MC group at the same time point but without evacuating the hematoma. All the animals were sacrificed within two weeks after the hematoma was surgically evacuated. A neurological deficit score was determined, and the perihematomal MMP-9 level and the BBB permeability were measured.
The neurological deficit score, perihematomal MMP-9 level and BBB permeability of the MI group decreased significantly compared to the MC group. Performing the MI procedure 6-12 h after intracerebral hemorrhage showed the most favorable outcome.
Regarding the pathophysiological changes surrounding the hematoma, the optimal time window of performing MI procedures for the intracerebral hematoma evacuation might be within 6-12 h after hemorrhage.
评估脑出血后不同阶段进行微创手术对血肿周围基质金属蛋白酶-9(MMP-9)表达及血脑屏障(BBB)通透性的影响。
60只家兔随机分为模型对照组(MC组,30只)和微创手术组(MI组,30只)。MC组和MI组均建立脑出血模型。在MI组中,脑出血成功诱导后6小时(6只)、12小时(6只)、18小时(6只)、24小时或48小时(6只)通过立体定向微创手术清除脑内血肿。MC组在相同时间点进行相同操作,但不清除血肿。所有动物在血肿手术清除后两周内处死。测定神经功能缺损评分,并检测血肿周围MMP-9水平和BBB通透性。
与MC组相比,MI组的神经功能缺损评分、血肿周围MMP-9水平和BBB通透性显著降低。脑出血后6-12小时进行MI手术效果最佳。
就血肿周围的病理生理变化而言,脑出血血肿清除术进行MI手术的最佳时间窗可能在出血后6-12小时内。