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目的 :探讨MCAO缺血侧不同部位缺血组织的病理演变特征 ,阐明缺血时间与神经元损伤程度的关系。方法 :利用线栓法MCAO模型 ,采取TTC和HE染色 ,光镜电镜观察MCAO不同时相点缺血侧基底节区、皮层和海马的损伤特征 ,并直接对坏死和暗神经元计数 ,运用对数方程作出缺血时间 -脑损伤程度关系曲线 ,运算ET5 0 值。结果 :缺血 30min ,坏死神经元首先大量出现在缺血侧基底节区 ,以后逐渐扩展到皮层 ,至缺血 2 4h后 ,缺血中心逐步出现凝固性坏死 ,缺血时间依赖性病理变化完全符合剂量反应曲线的S -形分布。结论 :MCAO后 ,MCA分布脑区的病理变化可分为组织水肿期、神经元急剧损伤期和凝固性坏死期三个阶段。治疗窗因阻塞血管和缺血部位及组织可逆的期望值不同而异。主张治疗窗应“个体化”
OBJECTIVE: To investigate the pathological changes of ischemic tissue in different parts of MCAO and to elucidate the relationship between ischemic time and neuronal damage. Methods: MCAO model was used to observe the damage characteristics of ischemic basal ganglia, cortex and hippocampus in MCAO at different time points by TTC and HE staining. The necrotic and dark neurons were counted directly. Number of equations to make the ischemic time - the relationship between the degree of brain injury curve, computing ET50 value. Results: After ischemia for 30 min, necrotic neurons firstly appeared in the ischemic basal ganglia and then gradually extended to the cortex. After 24 h of ischemia, the ischemic center gradually developed coagulation necrosis and the ischemic time-dependent pathological changes were complete S - shaped Distribution According to Dose Response Curve. Conclusion: After MCAO, the pathological changes of brain regions in MCA distribution can be divided into three stages: tissue edema stage, sharp neuron injury stage and coagulation necrosis stage. The window of treatment varies depending on the expected value of occlusion of blood vessels and the reversibility of ischemic sites and tissues. Advocate treatment window should be “individualized”