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目的 研究兔症状性蛛网膜下腔出血(SAH)后脑血管痉挛(CVS)与内皮素(ET)和一氧化氮(NO)的关系及川芎嗪的保护作用。方法 采用双侧颈动脉结扎和枕大池二次注血制成兔SAH模型,观察SAH前后动物进食量和神经功能改变,用放射免疫方法和硝酸还原酶法分别测定血液和脑脊液中ET和NOx-含量,以氢清除法测定局部脑血流量(rCBF)。结果 SAH后大部分动物进食量有不同程度的下降,所有动物均有不同程度的神经功能障碍和rCBF下降。SAH后血液和脑脊液中ET含量增加,NOx-含量下降(P<0.01)。上述变化随出血时间延长和出血量的增大而增加。川芎嗪治疗组上述变化均有不同程度的改善。结论 双侧颈动脉结扎后枕大池二次注血可制成可靠的兔症状性SAH后CVS的动物模型。兔SAH后ET和NO含量的改变与CVS的发生密切相关,并进而导致临床症状的恶化。川芎嗪可通过抑制SAH后ET和NO的变化而对CVS的发生和发展起到防治作用。
Objective To study the relationship between cerebral vasospasm (CVS), endothelin (ET) and nitric oxide (NO) after symptomatic subarachnoid hemorrhage (SAH) in rabbits and the protective effect of tetramethylpyrazine. Methods Rabbit SAH models were made by bilateral carotid artery ligation and double injection of occipital accompaniment. Animal feeding and neurological function changes were observed before and after SAH. ET and NOx were measured in blood and cerebrospinal fluid by radioimmunoassay and nitrate reductase method, respectively. Content, local cerebral blood flow (rCBF) was determined by hydrogen clearance. Results After SAH, the food intake of most animals decreased to varying degrees. All animals had varying degrees of neurological deficits and decreased rCBF. After the SAH, the ET content in blood and cerebrospinal fluid increased, and the NOx content decreased (P<0.01). The above changes increase with prolonged bleeding time and increased blood loss. The above changes in the Ligustrazine treatment group all improved to varying degrees. Conclusion The second injection of blood from the occipital aorta after bilateral carotid artery ligation can make a reliable animal model of CVS after symptomatic SAH in rabbits. The change of ET and NO content after SAH in rabbits is closely related to the occurrence of CVS, which in turn leads to the deterioration of clinical symptoms. Ligustrazine can prevent and treat CVS by inhibiting the changes of ET and NO after SAH.