目的探讨不同葡萄糖水平对缺氧缺血(HI)新生大鼠脑病理改变的影响。方法对7日龄SD新生大鼠通过调节葡萄糖注射液的注射次数及时间或禁食12h,分别建立单纯低血糖组、HI组、HI前低血糖组、HI后低血糖组、HI前轻度高血糖组、HI后轻度高血糖组、HI前重度高血糖组及HI后重度高血糖组;另设正常组和假手术组。各组新生大鼠分别均于HI后2、24、48、72h及7d断头处死,光镜下行脑病理检查并做病理评分结果HI后2、24、48、72h和7d各时段中,以HI前低血糖组的改变最为明显,HI后7d的病理评分高达280分。HI后低血糖组的病变程度仅次于HI前低血糖组(180分)。各组中以HI重度高血糖组的病变程度最轻(92分)。余各组病变程度。HI组相似(100分左右)。脑病理改变以坏北为主,存坏死灶边缘可见散住变性神经元。除HI前高血糖组的病变主要累及皮质外,各组在皮质及海马两个部位的受累几率基本均等。结论HI前低血糖可进一步加剧新生大鼠脑缺氧缺血性损害,HI前高血糖则可明显改善新生大鼠脑缺氧缺血性损伤。
Objective To explore the influence of different blood glucose levels on cerebral pathology under light microcopy in neonatal rats with hypoxic-ischemic (HI). Methods Seven-day old neonatal SD rats were randomly divided into 10 groups which eonsisted of normal group, sham group, group with hypoglycemia, HI group, group with hypoglycemia before HI, group with hypoglycemia after HI, group with mild hyperglycemia before HI, group with mild hyperglycemia after HI, group with higher hyperglycemia before HI, and group with higher hyperglycemia after HI. Cerebral pathological examination under light microscopy and pathological grade were undertaken in all neonatal rats of 10 groups at 2, 24, 48, 72 hours and 7 days after HI. Results There was a significant serious cerebral pathological change in group with hypoglycemia either before or after HI in particular before HI at eaeh period of time with scores of 280 in the former and of 180 in the latter in system of pathological grade. The cerebral pathological chang was mildest in group with higher hyperglycemia before HI with scores of 9, 2. The similar scores (about 100) were found in other groups eomparing with that in HI group. Necrosis was the major manifestation in cerebral pathological change and sporadic degenerative neuron could be seen in the margin of neerotic area. Pathological change in both of cortical layer and hipocamp was involved in all groups with HI except the group with higher hyperglycemia before HI in which pathological change was just found in cortical layer. Conclusion Hypoglycemia before HI can aggravate cerebral damage and higher hyperglycemia before HI can improve, cerebral damage in neonatal rats.