The Expression Of CD34 And SMA In The Subcapsular Hematoma Of Patients With Subacute And Chronic Subdural Hematoma

?Objective?By observing the expression of CD34 and SMA in the subcapsular hematoma and dural hematoma of patients with subacute and chronic subdural hematoma, to analysis subdural hematoma hematoma capsule in case the number of new blood capillaries and maturity, and to explore the hematoma capsule newborn capillary relationship between vascular and subdural hematoma diseases. ?Methods?To select 84 cases patients were diagnosed as subacute or chronic subdural hematoma by brain MRI in the Second Affiliated Hospital of Nanhua University Neurosurgery Inpatient. All patients have been excluded blood-related diseases, and no previous history of chronic dialysis and taking anticoagulant drugs. Selected number of cases are clear history of head injury, and the times of head injuries are more than 7 days. Specimens from patients with subdural hematoma and outer membrane specimen by drilling drainage, will be divided into control and experimental groups, according to patient injury time and brain MRI results will be divided into three periods: subacute late(7-14 days), chronic early(15-30 days) and chronic late(over 30 days). And by immunohistochemistry staining CD34(mark all endothelial cells) and-SMA(labeled vascular wall cells including vascular smooth muscle cells and pericytes), calculate the value of MVD and VNI, the experimental data subtotals and using SPSS 18.0 software. data statistics. ?Results?1?The observation under microscopic(40×10): the dura mater occupies most of dense fibrous tissue, and includes a small part of the small arteries and fibroblasts,which the small arterial wall is thick and basement membrane is integral. The outer membrane of hematoma were filled with most new capillaries and gathered more fibroblasts and inflammatory cells. A part of new blood capillaries basement membrane is incomplete, and the gap still existed a small amount of collagen fibers and fibroblasts, and capillary dilation was hyperemia(hemosidrin).2 ? CD34 marker mainly is on the outer membrane and dural hematoma of capillary endothelial cells. The expression of late subacute expression is 68.62±0.28, early chronic expression is 66.50±0.31, late chronic expression is 71.27±0.26. CD34 expression of the outer membrane of the hematoma value each period are as follows:late subacute expression is 123.74±4.35, early chronic expression is 131.92±4.19, late chronic expression is 128.68±3.06. Subdural hematoma expression of the outer membrane and the inner set of four periods CD34 showed no statistically significant difference, P value>0.05, not statistically significant. Expression of CD34 dura total average value is 69.80±2.49, hematoma outer membrane expression of CD34 total average value if 124.43±3.75, so CD34 expression in epicardial hematoma was above the dura, and the difference was statistically significant between the two phases(P<0.05).3?SMA mark hematoma on the outer membrane of the dura and the capillary wall cells, mainly mature capillaries marker expression, the expression of dura late subacute expression is 51.49±3.29, early chronic expression is 42.86±2.82, late chronic expression is 37.56±3.42, SMA expression of the outer membrane of the hematoma value each period are as follows: late subacute is 113.29±3.19, early chronic is 104.58 ± 3.85, late chronic is 97.73±2.83. And the difference was statistically significant(P <0.05). The total average dura SMA expression is 49.05±3.35, hematoma adventitia SMA expression of total average value of 108.24 ±3.29, SMA in the outer membrane of the hematoma was significantly higher than the expression of dura, the differences between them statistically significance(P <0.05).4?VMI values of the control group at different times were: 91.55% late subacute, chronic early 79.28%, 75.95% chronic late. Experimental group VMI values were: 75.04% late subacute, chronic early 64.45%, 52.70% chronic late. VMI value of patients in the experimental group were lower than the value of VMI in patients with stage in the control group and the average VMI value of the experimental group was also lower than the average VMI value of the control group. ?Conclusion? 1?hematoma capsule contains a lot of new capillaries, capillary structure and most unusual; 2?CD34 hematoma in patients with subacute and chronic subdural hematoma capsule showed high expression in the state, the occurrence of hematoma capsule newborn capillaries and subdural hematoma relevant disease; 3?SMA presented hematoma capsule low expression state, and the hematoma capsule VMI value is below the dura, the occurrence and development and maturity under the envelope capillary reflect subdural hematoma disease also relevant.