Matsumoto M, Iida Y, Wakamatsu H, Ohtake K, Nakakimura K, Xiong L, Sakabe T
Department of Anesthesiology-Resuscitology, Yamaguchi University School of Medicine, Ube, Japan.
Anesth Analg. 1999 Sep;89(3):696-702. doi: 10.1097/00000539-199909000-00031.
Little is known about the role of nitric oxide in the pathophysiology of spinal cord ischemia. We evaluated the effects of nitric oxide synthase (NOS) inhibition by N(G)-nitro-L-arginine-methyl ester (L-NAME) in rabbits whose abdominal aorta was occluded for 20 min (Experiment 1) or 25 min (Experiment 2). In Experiment 1, the L-NAME group (n = 6) received 3 mg/kg i.v. L-NAME, followed by an i.v. infusion of 3 mg x kg(-1). h(-1) until 6 h after reperfusion. Ischemia was induced 20 min after the start of L-NAME. The phenylephrine group (n = 6) received phenylephrine to maintain comparable blood pressure. The control group (n = 6) received saline. In Experiment 2, L-NAME (3 mg/kg i.v. L-NAME, followed by an i.v. infusion of 3 mg x kg(-1). h(-1) until 6 h after reperfusion) and phenylephrine groups (n = 6 each) were studied. Ischemia was induced 100 min after the start of L-NAME. Forty-eight hours after reperfusion, hindlimb motor function and histopathology of the spinal cord were examined. In Experiment 1, L-NAME and phenylephrine both improved neurologic outcome, with higher intraischemic blood pressures than saline. In Experiment 2, L-NAME worsened the neurologic and histopathologic outcome compared with phenylephrine. Attenuation of damage by L-NAME in Experiment 1 may be attributable to an intraischemic blood pressure increase. The worse outcome with L-NAME in Experiment 2 suggests that NOS inhibition exacerbates ischemic spinal cord damage.
Nonselective inhibition of nitric oxide synthase activity has aggravating effects on the neurologic and histopathologic outcome after transient spinal cord ischemia.
关于一氧化氮在脊髓缺血病理生理学中的作用,人们了解甚少。我们评估了用N(G)-硝基-L-精氨酸甲酯(L-NAME)抑制一氧化氮合酶(NOS)对兔腹主动脉闭塞20分钟(实验1)或25分钟(实验2)的影响。在实验1中,L-NAME组(n = 6)静脉注射3 mg/kg L-NAME,随后静脉输注3 mg·kg⁻¹·h⁻¹,直至再灌注后6小时。在开始注射L-NAME 20分钟后诱导缺血。去氧肾上腺素组(n = 6)给予去氧肾上腺素以维持可比血压。对照组(n = 6)给予生理盐水。在实验2中,研究了L-NAME组(静脉注射3 mg/kg L-NAME,随后静脉输注3 mg·kg⁻¹·h⁻¹,直至再灌注后6小时)和去氧肾上腺素组(每组n = 6)。在开始注射L-NAME 100分钟后诱导缺血。再灌注48小时后,检查后肢运动功能和脊髓组织病理学。在实验1中,L-NAME和去氧肾上腺素均改善了神经功能结局,缺血期间血压高于生理盐水组。在实验2中,与去氧肾上腺素相比,L-NAME使神经和组织病理学结局恶化。实验1中L-NAME减轻损伤可能归因于缺血期间血压升高。实验2中L-NAME导致更差的结局表明抑制NOS会加重缺血性脊髓损伤。
一氧化氮合酶活性的非选择性抑制对短暂性脊髓缺血后的神经和组织病理学结局有加重作用。