Qureshi Adnan I, Ali Zulfiqar, Suri M Fareed K, Shuaib Asfhaq, Baker Glen, Todd Kathryn, Guterman Lee R, Hopkins L Nelson
Department of Neurosurgery, Toshiba Stroke Research Center, University of Buffalo, State University of New York, USA.
Crit Care Med. 2003 May;31(5):1482-9. doi: 10.1097/01.CCM.0000063047.63862.99.
To determine whether extracellular concentrations of glutamate and other amino acids are significantly elevated after intracerebral hemorrhage and, if so, the temporal characteristics of these changes. Although the role of excitotoxic amino acids, particularly that of glutamate, has been described in ischemic stroke and head trauma, no information exists regarding their possible contribution to the pathogenesis of neuronal injury in intracerebral hemorrhage.
Prospective, controlled, laboratory trial.
Animal research laboratory.
Sixteen anesthetized New Zealand rabbits.
We introduced intracerebral hemorrhage in each of eight anesthetized New Zealand rabbits by injecting 0.4 mL of autologous blood under arterial pressure into the deep gray matter of the cerebrum.
Extracellular fluid samples were collected from the perihematoma region and contralateral (right) hemisphere by in vivo microdialysis at 30-min intervals for 6 hrs. Corresponding samples were similarly collected from both hemispheres in each of eight control animals that underwent needle placement without introduction of a hematoma. Concentrations of amino acids (glutamate, aspartate, asparagine, glycine, taurine, and gamma-aminobutyric acid) in the samples were measured by use of high-pressure liquid chromatography with fluorescence detection. Glutamate concentrations (mean +/- sem) were significantly higher in the hemisphere ipsilateral to the hematoma than in the contralateral hemisphere (92 +/- 22 pg/microL vs. 22 +/- 6 pg/microL) at 30 mins after hematoma creation. A significant increase was observed at 30 mins posthematoma creation in the hemisphere ipsilateral to the hematoma compared with the baseline value. A nonsignificant increase in glutamate concentration persisted in the hemisphere ipsilateral to the hematoma, ranging from 134% to 187% of baseline value between 1 and 5 hrs after hematoma creation. In the hemisphere ipsilateral to the hematoma, a three-fold increase in the concentration of glycine was observed at 30 mins after hematoma creation compared with the baseline level (890 +/- 251 pg/microL vs. 291 +/- 73 pg/microL). There was a significant difference between the hemisphere ipsilateral to the hematoma compared with the ipsilateral (corresponding) hemisphere of the control group at 30 mins posthematoma (890 +/- 251 pg/microL vs. 248 +/- 66 pg/microL). A similar transient increase was observed in taurine and asparagine concentrations at 30 mins after hematoma creation, compared with baseline measurements. Taurine concentrations in the hemisphere ipsilateral to the hematoma were significantly higher than the ipsilateral hemisphere of the control group (622 +/- 180 pg/microL vs. 202 +/- 64 pg/microL) at 30 mins after hematoma creation.
The present study suggests that glutamate and other amino acids accumulate transiently in extracellular fluids in the perihematoma region during the early period of intracerebral hemorrhage. The exact role of these amino acids in the pathogenesis of neuronal injury observed in intracerebral hemorrhage needs to be defined.
确定脑出血后细胞外谷氨酸及其他氨基酸浓度是否显著升高,若升高,明确这些变化的时间特征。尽管兴奋性毒性氨基酸,尤其是谷氨酸,在缺血性中风和头部创伤中的作用已有描述,但关于它们在脑出血所致神经元损伤发病机制中的可能作用尚无相关信息。
前瞻性、对照、实验室试验。
动物研究实验室。
16只麻醉的新西兰兔。
对8只麻醉的新西兰兔,在动脉压下将0.4 mL自体血注入大脑深部灰质,造成脑出血。
通过体内微透析,每隔30分钟从血肿周围区域和对侧(右侧)半球采集细胞外液样本,持续6小时。对另外8只仅进行针穿刺而未形成血肿的对照动物,同样从双侧半球采集相应样本。采用带荧光检测的高压液相色谱法测量样本中氨基酸(谷氨酸、天冬氨酸、天冬酰胺、甘氨酸、牛磺酸和γ-氨基丁酸)的浓度。血肿形成后30分钟,血肿同侧半球的谷氨酸浓度(均值±标准误)显著高于对侧半球(92±22 pg/μL 对 22±6 pg/μL)。与基线值相比,血肿同侧半球在血肿形成后30分钟谷氨酸浓度显著升高。血肿形成后1至5小时,血肿同侧半球谷氨酸浓度持续非显著升高,为基线值的134%至187%。在血肿同侧半球,与基线水平相比,血肿形成后30分钟甘氨酸浓度增加了两倍(890±251 pg/μL 对 291±73 pg/μL)。血肿形成后30分钟,血肿同侧半球与对照组同侧(相应)半球相比有显著差异(890±251 pg/μL 对 248±66 pg/μL)。与基线测量值相比,血肿形成后30分钟牛磺酸和天冬酰胺浓度也有类似的短暂升高。血肿形成后30分钟,血肿同侧半球的牛磺酸浓度显著高于对照组同侧半球(622±180 pg/μL 对 202±64 pg/μL)。
本研究表明,脑出血早期血肿周围区域细胞外液中谷氨酸及其他氨基酸会短暂蓄积。这些氨基酸在脑出血所致神经元损伤发病机制中的确切作用有待明确。