Kamei T, Isshiki A
Department of Anesthesiology, Tokyo Medical University.
Masui. 2000 Apr;49(4):352-60.
The significance of mild-hypothermia as a treatment of brain ischemia-induced neuronal cell death was investigated by measurement of hippocampul excitatory amino acids, brain lactate and energy-charge just after 10 min of transient forebrain ischemia in a rat model with four vessels occluded. After 10 min of ischemia, cerebral circulation was restored. At that time, in the control group transient increases of hippocampul aspartate and glutamic acid levels were observed. Furthermore, brain lactate levels were also elevated but the energy-charge was reduced. These significant changes were observed in the non-isoflurane anesthesia and mild-hypothermia rats (control group). However, in rats with treatment of either isoflurane or mild-hypothermia, the excessive amount of amino acids and the significant fluctuation of brain metabolic/energy pathway seen in the control group were suppressed. Particularly, in the combined treatment group, these increased and decreased phenomena induced by brain ischemia were significantly inhibited. In a group of pre- and post-treatment of mild-hypothermia, the maximum peak of lactate was significantly less than that seen in the control group, although the sustained increased level of lactate was detected. These results indicate that the combined treatment with isoflurane anesthesia and mild-hypothermia is a suitable treatment for the brain dysfunction induced by ischemia and that the sustained hypothermia may help restore brain lactate levels after brain ischemia because of the lasting anaerobic metabolism.
在四动脉闭塞大鼠模型中,通过测量短暂性前脑缺血10分钟后海马兴奋性氨基酸、脑乳酸和能荷,研究了亚低温作为脑缺血诱导神经元细胞死亡治疗方法的意义。缺血10分钟后,恢复脑循环。此时,在对照组中观察到海马天冬氨酸和谷氨酸水平短暂升高。此外,脑乳酸水平也升高,但能荷降低。在非异氟烷麻醉和亚低温大鼠(对照组)中观察到这些显著变化。然而,在接受异氟烷或亚低温治疗的大鼠中,对照组中出现的过量氨基酸以及脑代谢/能量途径的显著波动受到抑制。特别是,在联合治疗组中,脑缺血诱导的这些增减现象受到显著抑制。在一组亚低温预处理和后处理的大鼠中,尽管检测到乳酸水平持续升高,但其最大峰值明显低于对照组。这些结果表明,异氟烷麻醉和亚低温联合治疗是治疗缺血诱导脑功能障碍的合适方法,并且由于持续的无氧代谢,持续低温可能有助于恢复脑缺血后的脑乳酸水平。