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目的 探讨人脑梗死后星形胶质细胞活性与凋亡的关系。方法 应用 10例脑梗死后的尸检全脑标本 ,用HE和免疫组化方法检测胶质纤维酸性蛋白 (GFAP)、凋亡相关蛋白 (Bcl 2 ) ,进行定性和定量分析。结果 人脑梗死后以梗死灶为中心 ,按照组织损伤程度由内到外分为 4个区 (0～ 3区 ) ,其中 2区为半暗带区 ,4 0 %以上的神经元和星形胶质细胞形态基本正常 ,随缺血时间延长 ,星形胶质细胞增生明显 ,形态正常神经元的数量减少 ;3区神经元形态及数量正常 ,星形胶质细胞反应性增生。GFAP在 0区和 1区表达很少 ,2区随缺血时间延长阳性细胞数增多 ,3区早期即有星形胶质细胞的簇样增生。Bcl 2在 0区无表达 ,1区表达较少 ,2区于缺血后 8h开始出现 ,2 3h达高峰 ,之后开始下降。结论 人脑梗死后在半暗带区 2 3h前GFAP和Bcl 2表达呈正相关 ;2 3h后呈负相关。 2区是临床需要积极抢救的区域 ,并可应用干预因素上调Bcl 2表达 ,缩小梗死面积。
Objective To investigate the relationship between astrocyte activity and apoptosis after cerebral infarction. Methods Ten brain autopsy samples of cerebral infarction were collected. The glial fibrillary acidic protein (GFAP) and apoptosis related protein (Bcl 2) were detected by HE and immunohistochemistry, and qualitative and quantitative analysis was performed. Results The cerebral infarction was taken as the center and divided into 4 zones (0 ~ 3 zones) according to the degree of tissue damage. The zone 2 was the penumbra zone, more than 40% neurons and the star Astrocytes morphology was normal, with prolonged ischemia, astrocyte proliferation, the number of normal neurons decreased; 3 neurons in normal morphology and quantity, astrocyte reactive hyperplasia. GFAP expression in the 0 and 1 area is very small, 2 area with ischemic time prolonging the number of positive cells increased, as early as 3 area with astrocyte cluster hyperplasia. Bcl 2 was not expressed in region 0, but was less expressed in region 1. Region 2 began to appear at 8 h after ischemia, peaked at 23 h and then began to decline. Conclusion The expression of Bcl-2 and GFAP in the penumbra zone 2 h after cerebral infarction is positively correlated, but negatively correlated after 23 h. Zone 2 is an area that is actively treated for clinical needs and can be used to up-regulate Bcl 2 expression and reduce infarct size.