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环氧化酶阻滞剂布洛芬对新生仔猪正常碳酸血症和高碳酸血症期间脑血容量和脑血流量的影响。

Effect of the cyclo-oxygenase blocker ibuprofen on cerebral blood volume and cerebral blood flow during normocarbia and hypercarbia in newborn piglets.

作者信息

Pellicer A, Aparicio M, Cabañas F, Valverde E, Quero J, Stiris T A

机构信息

Department of Neonatology, La Paz University Hospital, Madrid, Spain.

出版信息

Acta Paediatr. 1999 Jan;88(1):82-8. doi: 10.1080/08035259950170664.

Abstract

Indomethacin modifies baseline cerebral haemodynamics and metabolism, as well as vasomotor adaptive responses. However, the significance of arachidonic acid metabolites in the regulation of cerebral circulation remains unclear. A study was made of the effect of inhibition of the cyclo-oxygenase pathway on baseline cerebral haemodynamics and CO2-induced vasodilation using the more specific cyclo-oxygenase blocker ibuprofen in a neonatal pig model. Two methods were used: radiolabelled microspheres to measure cerebral blood flow and near infrared spectroscopy to calculate absolute changes in cerebral blood volume. The relationship between CO2-induced changes in these two haemodynamic parameters was evaluated. Fifteen newborn piglets <7 d old received an i.v. infusion of either ibuprofen (30 mg/kg) (IB group, n = 8) or saline (control group, n = 7). Cerebral blood flow and absolute changes in cerebral blood volume were measured while the piglets were breathing room air at baseline and 30 min after infusion of ibuprofen or saline, and 15 min and 30 min after inducing hypercarbia. Global and regional cerebral blood flow (ml/hg/min) and absolute changes in cerebral blood volume (ml/hg) did not vary between baseline and 30 min after infusion of ibuprofen or saline. During hypercarbia, global and regional cerebral blood flow and absolute changes in cerebral blood volume increased significantly in both the ibuprofen and control groups (p < 0.01). The mean percentage increases in blood flow and blood volume at each measurement were almost identical, with approximately 90% of the increase in both parameters occurring after 15 min of hypercarbia, then reaching a plateau. However, we found no agreement between cerebral blood flow changes and absolute changes in cerebral blood volume. We conclude that ibuprofen did not alter either baseline cerebral circulation or physiological CO2-induced vasodilation in newborn pigs. We speculate that hypercarbic cerebral vasodilation could be caused either by mediators other than the cyclo-oxygenase metabolites of arachidonic acid or by a direct effect on vessel walls.

摘要

吲哚美辛可改变脑血流动力学和代谢的基线水平,以及血管舒缩适应性反应。然而,花生四烯酸代谢产物在脑循环调节中的意义仍不明确。本研究采用更具特异性的环氧化酶阻滞剂布洛芬,在新生猪模型中研究环氧化酶途径抑制对基线脑血流动力学及二氧化碳诱导的血管舒张的影响。使用了两种方法:放射性微球测量脑血流量,近红外光谱法计算脑血容量的绝对变化。评估了二氧化碳诱导的这两个血流动力学参数变化之间的关系。15只7日龄以内的新生仔猪接受静脉输注布洛芬(30mg/kg)(IB组,n = 8)或生理盐水(对照组,n = 7)。在仔猪呼吸室内空气时、输注布洛芬或生理盐水后30分钟、诱导高碳酸血症后15分钟和30分钟,测量脑血流量和脑血容量的绝对变化。输注布洛芬或生理盐水后30分钟与基线相比,全脑和局部脑血流量(ml/hg/min)以及脑血容量的绝对变化(ml/hg)无差异。在高碳酸血症期间,布洛芬组和对照组的全脑和局部脑血流量以及脑血容量的绝对变化均显著增加(p < 0.01)。每次测量时血流量和血容量的平均百分比增加几乎相同,两个参数约90%的增加发生在高碳酸血症15分钟后,然后达到平台期。然而,我们发现脑血流量变化与脑血容量的绝对变化之间不一致。我们得出结论,布洛芬不会改变新生猪的基线脑循环或生理性二氧化碳诱导的血管舒张。我们推测,高碳酸血症性脑血管舒张可能是由花生四烯酸的环氧化酶代谢产物以外的介质引起的,也可能是对血管壁的直接作用所致。

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