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目的 从形态学基础探讨脑过度灌注的发生机理。方法 透射电镜下观察不同时相的脑盗血和脑过度灌注动物局部脑组织超微结构。结果 慢性脑盗血大鼠毛细血管周围星形胶质细胞足突层 (AsF)肿胀 ,胞浆稀疏呈空泡化 ,AsF层空泡化程度较急性、亚急性者严重 (P <0 0 1)。邻近的星形胶质细胞 (As)出现相似的空泡化等改变 ,神经元细胞 (NC)形态改变不如As明显。脑过度灌注发生后 ,慢性脑盗血区BBB结构完整性严重破坏。结论 在慢性脑盗血状态下 ,As最先发生形态学异常。BBB超微结构的改变以AsF层空泡化为特征 ,构成了脑过度灌注发生的形态学基础。当脑微血管网承受血流高灌注时 ,BBB进一步破坏 ,组织水肿形成。
Objective To explore the mechanism of brain over-infusion from the basis of morphology. Methods Under the transmission electron microscope, we observed the intracerebral brain ultrastructure of traumatic brain and over-perfusion in different phases. Results Astrocytes around the capillaries of rats with chronic cerebral steal had swollen astigmatism, with sparse cytoplasm vacuolization, more vacuolization of AsF layer and severe subacute (P <0.01) ). Adjacent astrocytes (As) appeared similar vacuolization and other changes in neuronal cell (NC) morphological changes than As obvious. After cerebral perfusion, the structural integrity of BBB in chronic cerebral steal area is severely damaged. Conclusion In the chronic state of steal, As is the first morphological abnormalities. The ultrastructural changes of BBB are characterized by vacuolization of AsF layer, which constitutes the morphological basis of brain overperfusion. When the brain microvascular network to withstand high perfusion, BBB further damage, tissue edema formation.