BACKGROUND: Recent studies have suggested that mitochondrial ATP-sensitive K+ channel openers could reduce myocardium infarct size, and protect the function of the mitochondria.OBJECTIVE: To investigate the changes of cerebral infarction volume and the activity of marker enzymes in brain mitochondria of rats given the ATP-sensitive K+ channel opener, nicorandil, before focal cerebral ischemia/reperfusion (I/R).DESIGN, TIME AND SETTING: Randomized, controlled animal experiment, completed at the Brain Scientific Research Center of the Affiliated Hospital of Qingdao University from July to November 2007.MATERIALS: Sixty healthy male Wistar rats weighing 280-300g. Nicorandil, 5-hydroxydecanoate (5-HD) and cytochrome C were purchased from Sigma in the USA. Standard malondialdehyde (MDA) and protein were purchased from Nanjing Jiancheng Biotechnology Institute.METHODS: Sixty rats were randomly divided into a sham operation group, a middle cerebral artery occlusion (MCAO) group, a nicorandil group and a nicorandil+5-HD group. MCAO for 2 hours was performed in the MCAO group, nicorandil group and nicorandil+5-HD group. A total of 5mL saline were given to the MCAO group before MCAO. The nicorandil group was injected with the ATP-sensitive K+ channel opener nicorandil 10mg/kg intraperitoneally 30 minutes before MCAO. The nicorandil+5-HD group was injected with 5-HD 10mg/kg intravenously 15 minutes before the same treatment as the nicorandil group.MAIN OUTCOME MEASURES: Infarct volume by total brain slice calculation, activities of succinate dehydrogenase (SDH) and cytochrome oxidase (CO), and content of MDA were observed at 22 hours of reperfusion after 2 hours MCAO.RESULTS: Sixty rats were included in the final analysis, without any loss. (1) Infarct volume: compared with the MCAO group and nicorandil+5-HD group, the percentage of infarct volume was significantly decreased in the nicorandil group (P<0.01). (2) The content of MDA, expression of SDH and CO in brain: the expressions of SDH and CO in the sham operation group were significantly lower than those in the MCAO, nicorandil and nicorandil+5-HD groups (P<0.01). The expressions of SDH and CO in the nicorandil group were significantly higher than those in the MCAO and nicorandil+5-HD groups (P<0.05). The content of MDA in the brain of the nicorandil group was significantly lower than those in the MCAO and nicorandil+5-HD groups (P<0.01).CONCLUSION: Nicorandil can significantly reduce the infarct volume in a rat MCAO model, increase the activity of the mitochondria and protect against cerebral I/R injury.