Sönmez O F, Unal B, Inalöz S, Sahin B, Yilmaz M, Aydin A, Kaplan S
Department of Neurosurgery, Medical School Ondokuz Mayis University, Samsun, Turkey.
Acta Neurochir (Wien). 2002 Sep;144(9):921-8; discussion 928. doi: 10.1007/s00701-002-0971-0.
Vasospasm is one of the underlying causes of morbidity and mortality in subarachnoid haemorrhage (SAH). The therapeutic effects of intracarotid infusion of spermine/nitric oxide complex (SPER/NO) on cerebral vasospasm in an experimental model of SAH were investigated.
Twenty-four adult male New Zealand white rabbits (2.6-3.4 kg in weight) were randomly divided into four groups (n=6), as follows: (I) control group (without SAH and drug), (II) SAH alone group (with SAH, without drug), (III) SAH placebo group (with SAH and saline), and (IV) SAH-SPER/NO group (with SAH and SPER/NO). The fresh autologous non-heparinized blood was injected into the cisterna magna to induce a SAH, after 24 hour SAH, the substance (saline or SPER/NO) was delivered to animals. All rabbits were scarified at 48-hours of induced SAH. The basilar artery with surrounding tissue was removed from the cranium and processed for paraffin embedding. Histopathological and stereological examinations of the basilar artery were done.
In the SPER/NO treated group of rabbits, the histopathological changes were less severe than in the SAH-alone and SAH-placebo groups. Regarding the intracarotid pressure, there was a statistically significant difference between SAH-alone and SAH-SPER/NO groups and also between SAH-SPER/NO and control groups (p<0.05). The mean cross sectional area of basilar arteries was 0.26 mm(2) in the control, whereas in SAH alone, placebo and SAH-SPER/NO groups were 0.13, 0.15 and 0.20 mm(2), respectively.
It is well known that NO is a critical substance involved in cerebral vascular dynamics. Present results indicate that treatment of vasospasm with SPER/NO in SAH may be promising. However, further studies should be done on this substance to clarify its effect on vasospasm before using the drug in clinical situations.
血管痉挛是蛛网膜下腔出血（SAH）发病和死亡的潜在原因之一。研究了在SAH实验模型中，经颈内动脉输注精胺/一氧化氮复合物（SPER/NO）对脑血管痉挛的治疗效果。
将24只成年雄性新西兰白兔（体重2.6 - 3.4千克）随机分为四组（每组n = 6），如下：（I）对照组（无SAH且未用药），（II）单纯SAH组（有SAH，未用药），（III）SAH安慰剂组（有SAH且用生理盐水），以及（IV）SAH - SPER/NO组（有SAH且用SPER/NO）。将新鲜自体未肝素化血液注入枕大池以诱导SAH，SAH 24小时后，给动物给予相应物质（生理盐水或SPER/NO）。所有兔子在诱导SAH 48小时后处死。从颅骨中取出基底动脉及其周围组织，进行石蜡包埋。对基底动脉进行组织病理学和体视学检查。
在接受SPER/NO治疗的兔组中，组织病理学变化比单纯SAH组和SAH安慰剂组轻。关于颈内动脉压力，单纯SAH组与SAH - SPER/NO组之间以及SAH - SPER/NO组与对照组之间存在统计学显著差异（p < 0.05）。对照组基底动脉的平均横截面积为0.26平方毫米，而单纯SAH组、安慰剂组和SAH - SPER/NO组分别为0.13、0.15和0.20平方毫米。
众所周知，NO是参与脑血管动力学的关键物质。目前的结果表明，在SAH中用SPER/NO治疗血管痉挛可能是有前景的。然而，在临床应用该药物之前，应对该物质进行进一步研究以阐明其对血管痉挛的作用。
