人脑挫伤后波形蛋白表达的免疫组化染色观察

目的观察人脑挫伤后波形蛋白（vimentin，Vim）的动态变化，探讨星形胶质细胞Vim表达变化与脑损伤时间的关系。方法42例闭合性脑损伤死亡者，根据伤后死亡时间分为6组（〈2h，〈24h，〈3d，〈7d，〈14d，≤30d）；取大脑挫伤灶进行HE和Vim免疫组织化学染色，对Vim染色阳性细胞面积进行图像分析。结果HE染色显示，脑挫伤后2h挫伤灶内脑组织挫碎、出血，5．5h挫伤灶周出现反应性星形胶质细胞，3d脑水肿明显，7d反应性星形胶质细胞明显增多，14d胶质结节形成，30d出现大量泡沫细胞，胶质瘢痕增多。Vim染色结果显示，脑挫伤后5．5hVim开始表达，少量Vim阳性细胞出现在挫伤灶周围，7d阳性反应性最强，14d逐渐下降，30d胶质瘢痕增多，Vim阳性表达又增强。Vim阳性细胞主要为反应性星形胶质细胞。结论Vim在反应性星形胶质细胞内表达呈现一定波动性，其表达部位在脑挫伤周围，Vim免疫组化染色结合图像分析技术可作为推断脑挫伤时间及部位的参考指标。

The vimentin expression changes followed posttraumatic human brain tissues

Objective Study the dynamic changes of vimentin(Vim) after brain contusion in human, explore the correlation between the Vim expression and the posttraumatic intervals due to the cerebral contusion in human.Methods Samples of confirmed cerebral contusion were collected from 42 cases with closed head injury.All cases were divided into 6 groups according to the death time(<2h,<24h,<3d,<7d,<14d,≤30d).Conventional histological HE staining and immunohistochemical staining of Vim were performed.The results were analyzed by image analysis technique.Results HE staining showed,the brain tissues frustrated,hemorrhaged in the contusion focuses at 2h post trauma.The reactive astrocytes began to appear in regions around brain contusion sites at 5.5 hours after injury.The brain edema was obious at 3d post trauma.The quantity of the reactive astrocytes increased obviously at 7d after the injury.The glial nodus formed at 14d post trauma.The number of glial scar increased and a large amount of foam cells appeared at 30d post trauma.Immunohistochemical staining showed,Vim began to be expressed at 5.5 hours after injury and only a few Vim-positive cells were located in regions around cerebral contusion sites. The quantity of the Vim-positive cells peaked in at 7d after the injury,and thereafter declined gradually at 14d post trauma.The number of glial scar and Vim-positive cells both increased at 30d post trauma. Vim-positive cells were reactive astrocytes.Conclusion The expression of Vim in reactive astrocytes showed certain fluctuation,expressed in regions around cerebral contusion sites.Detection of Vim by immunohistochemical staining in combination with image analysis technique could be used for estimation of the posttraumatic interval of the brain contusion.