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目的：研究颅脑损伤早期血脑屏障通透性（ＢＢＢＰ）、磷脂酶Ａ２（ＰＬＡ２）与脑水肿的改变及其相关关系；以及地塞米松和尼莫地平治疗的影响。方法：应用鼠脑液压伤模型，观测伤后不同时间伊文氏蓝在伤侧脑组织内吸光度变化、ＰＬＡ２和脑含水量改变；并观测经腹腔注射地塞米松和尼莫地平后上述指标的改变。结果：液压伤后１小时伤侧脑组织伊文氏蓝吸光度开始升高，伤后６小时至峰值，随后逐渐降低，伤后１２小时～７２小时仍维持在高于对照组１倍以上的水平；ＰＬＡ２于液压伤后１小时发生改变，１２小时～２４小时达峰值，４８小时～７２小时仍高于对照组；脑含水量在伤后２４小时～７２小时呈阶梯状升高；创伤早期ＢＢＢＰ的改变程度较ＰＬＡ２和脑含水量明显；ＢＢＢＰ与ＰＬＡ２和脑含水量均呈正相关。结论：①创伤早期ＢＢＢＰ增加是由脑血管功能紊乱和机械物理损伤所致，也是ＰＬＡ２升高和血管源性脑水肿形成的诱因；②创伤后２４小时～７２小时ＰＬＡ２的升高，导致细胞毒性脑水肿，促使血脑屏障结构破坏，ＢＢＢＰ增加，脑继发性损伤加重，３者间呈互相增强作用；③早期应用大剂量地塞米松和尼莫地平治疗对抑制ＰＬＡ２的活性、降低ＢＢＢＰ和减轻脑水肿有显著疗效
OBJECTIVE: To study the changes of BBB, PLA2 and brain edema in early stage of brain injury and their correlation, and the effects of dexamethasone and nimodipine. Methods: The rat model of hydrocephalus was used to observe the changes of absorbance in injured brain tissue and the changes of PLA2 and brain water content of Evans blue at different time points. The changes of these indexes were observed after intraperitoneal injection of dexamethasone and nimodipine . Results: The absorbance of Evans blue in injured brain tissue began to increase at 1 hour after injury, and peaked at 6 hours after injury. The absorbance gradually decreased from 1 hour to 12 hours after injury. PLA2 peaked at 12 hours to 24 hours and remained higher at 48 hours to 72 hours than those in control group. Brain water content increased in steps from 24 hours to 72 hours after injury. The level of BBBP The degree of change was more obvious than PLA2 and brain water content. BBBP was positively correlated with PLA2 and brain water content. Conclusion: ① The early stage of trauma BBBP increased by cerebral vascular dysfunction and mechanical and physical damage caused by PLA2 is also an inducement of vasogenic brain edema; ② 24 hours to 72 hours after trauma increased PLA2, leading to cytotoxicity Brain edema, promote the destruction of the blood-brain barrier structure, BBBP increased secondary brain injury increased, the three were mutually reinforcing; ③ Early high-dose dexamethasone and nimodipine treatment on the inhibition of PLA2 activity, lower BBBP and Reduce brain edema have a significant effect