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目的进一步阐明蛛网膜下腔出血（ＳＡＨ）后迟发性脑血管痉挛（ＤＣＶＳ）的发病机制及其与免疫炎症反应的关系。方法青紫蓝兔２０只，随机分为ＳＡＨ组（１４只）和假ＳＡＨ组（６只），采用枕大池二次注血法造成ＳＡＨ模型，假ＳＡＨ组用ＮＳ代替注血。６天后灌流固定法处死动物，取其基底动脉中１／３段送光镜及电镜观察。结果ＳＡＨ组血管壁增厚、结构紊乱，管腔狭窄，内弹力膜皱折，内皮细胞及平滑肌细胞中线粒体增多、变性和溶酶体增加，以及内弹力膜虫蚀样改变等。假ＳＡＨ组血管形态结构正常。结论ＳＡＨ后ＤＣＶＳ与痉挛血管发生了明显病理变化有关，并可能与ＳＡＨ后局部免疫炎症反应有密切关系。
Objective To elucidate the pathogenesis of delayed cerebral vasospasm (DCVS) after subarachnoid hemorrhage (SAH) and its relationship with immune inflammation. Methods Twenty rabbits were randomly divided into SAH group (n = 14) and sham SAH group (n = 6). The SAH model was induced by the second injection of occipital cistern and the NS was replaced by fake SAH group. After 6 days, the animals were sacrificed by peritoneal perfusion method, and the light transmission and transmission electron microscopy of the basilar artery were performed. Results In the SAH group, there were thickening of vascular wall, structural disorder, stenosis of the lumen, wrinkles of the inner elastic membrane, increase of mitochondria in endothelial cells and smooth muscle cells, increase of degeneration and lysosome, and alteration of the endometriosis. False SAH group vascular structure is normal. Conclusions DCVS is associated with obvious pathological changes of spasm blood vessels after SAH and may be closely related to local immune inflammation after SAH.