Meldrum B S, Nilsson B
Brain. 1976 Sep;99(3):523-42. doi: 10.1093/brain/99.3.523.
Cerebral blood flow (CBF) and cerebral metablic rate for oxygen (CMRO2) have been studied during sustained epileptic seizures induced by bicuculline (1-2 mg/kg, i.v.) in paralysed Wistar rats, artificially ventilated with nitrous oxide/oxygen. CBF was determined by venous outflow collection, and by 133Xe desaturation, using sagittal sinus blood (for cerebral cortical flow) or retroglenoid venous blood (for 'whole brain' flow). The procedure employed ensured that arterial oxygenation remained normal and blood glucose concentration was normal or high throughout the seizure. Arterial hypotension was prevented by the infusion of donor blood. CBF increased concurrently with seizure onset, reaching a maximum nine times higher than control value after 15-60 s. This was due to a marked rise in mean arterial pressure (to greater than 180 torr) and a dramatic fall in cerebrovascular resistance to less than 15 per cent of control). Subsequently, with decreasing blood pressure, CBF slowly diminished, being more than four times higher than control at 20 min, and slightly less than three times higher than control at two hours. The different procedures for measuring CBF gave closely similar results. A threefold increase relative to control CMRO2 (7-6 ml/100 g-1/min-1 for 'whole brain,' and 10-2 ml/100 g-1/min-1 for cerebral cortex) was measured after 1-20 min of seizure activity (utilizing either the venous outflow or the 133Xe desaturation procedure for CBF determination). After two hours of seizure activity CMR02 was still more than twice as high as the control. This high metabolic rate during sustained seizure activity will increase the susceptibility of the brain to 'ischaemic' damage during prolonged seizures in man in which an additional metabolic stress may be imposed by cerebral hypoxia, arterial hypotension, hyperpyrexia or hypoglycaemia.
在使用荷包牡丹碱(1-2毫克/千克,静脉注射)诱导的持续性癫痫发作期间,对用氧化亚氮/氧气人工通气的麻痹Wistar大鼠的脑血流量(CBF)和脑氧代谢率(CMRO2)进行了研究。CBF通过静脉流出物收集和133Xe去饱和来测定,使用矢状窦血(用于脑皮质血流)或关节后静脉血(用于“全脑”血流)。所采用的程序确保在整个癫痫发作期间动脉氧合保持正常,血糖浓度正常或偏高。通过输注供血来预防动脉低血压。CBF与癫痫发作开始同时增加,在15-60秒后达到比对照值高九倍的最大值。这是由于平均动脉压显著升高(超过180托)和脑血管阻力急剧下降至对照的不到15%。随后,随着血压下降,CBF缓慢减少,在20分钟时比对照高四倍多,在两小时时比对照高略少于三倍。测量CBF的不同程序给出了非常相似的结果。在癫痫活动1-20分钟后(使用静脉流出或133Xe去饱和程序测定CBF),相对于对照CMRO2增加了三倍(“全脑”为7-6毫升/100克-1/分钟-1,脑皮质为10-2毫升/100克-1/分钟-1)。癫痫活动两小时后,CMR02仍比对照高两倍多。在持续性癫痫活动期间这种高代谢率将增加人脑在长时间癫痫发作期间对“缺血性”损伤的易感性,在长时间癫痫发作中,脑缺氧、动脉低血压、高热或低血糖可能会施加额外的代谢应激。