Perez-Trepichio A D, Furlan A J, Little J R, Jones S C
Department of Neuroscience, Cleveland Clinic Foundation, Ohio 44195-5286.
Stroke. 1992 Dec;23(12):1782-90; discussion 1790-1. doi: 10.1161/01.str.23.12.1782.
We evaluated isovolumic hemodilution with hydroxyethyl starch 200/0.5 in a rat model of focal cerebral ischemia. This compound avoids the unfavorable viscosity and erythrocyte aggregation abnormalities of low molecular weight dextran during administration over a period of several days.
Sprague-Dawley rats, anesthetized with 0.5-1% halothane and 70% N2O, were subjected to silicon cylinder (treated and control groups) or sham (sham group) embolization of the cerebral circulation. Thirty minutes after embolization, the treated group (n = 5) was infused with 11 ml/kg of 10% hydroxyethyl starch 200/0.5, and the control (n = 5) and sham (n = 4) groups were infused with saline for 1 hour. In the treated group, 7.1 ml/kg of blood was withdrawn. After 24 hours, the animals were reanesthetized, and cerebral blood flow was determined with [14C]iodoantipyrine. Alternative brain slices were either incubated with 2,3,5-triphenyltetrazolium chloride for infarct volume determination or frozen for ischemic volume and cerebral blood flow determination using autoradiography.
The hematocrit in the treated group was reduced from (mean +/- SEM) 46 +/- 1% to 35 +/- 2% at 1.5 hours (p < 0.01). Cortical blood flow was within the normal range of 115-185 ml/min/100 g, except for the ischemic cortex in the embolized groups, treated and control. The ischemic and infarct volume of the treated group was reduced by 74% (p < 0.05) and 89% (p < 0.05), respectively, from the control group. The treated and sham ischemic and infarct volumes were not statistically different.
These data suggest that hydroxyethyl starch 200/0.5 could be an effective treatment for ischemic stroke when administered early, because it reduces infarct and ischemic volumes from control values to levels indistinguishable from those of the sham group.
我们在大鼠局灶性脑缺血模型中评估了200/0.5羟乙基淀粉的等容血液稀释作用。该化合物避免了在数天给药期间低分子右旋糖酐的不利粘度和红细胞聚集异常。
用0.5 - 1%氟烷和70%氧化亚氮麻醉的Sprague-Dawley大鼠，接受脑循环的硅圆柱栓塞（治疗组和对照组）或假手术（假手术组）。栓塞30分钟后，治疗组（n = 5）输注11 ml/kg的10% 200/0.5羟乙基淀粉，对照组（n = 5）和假手术组（n = 4）输注生理盐水1小时。治疗组抽取7.1 ml/kg血液。24小时后，动物再次麻醉，用[14C]碘代安替比林测定脑血流量。交替的脑切片要么用2,3,5 - 三苯基四氮唑氯化物孵育以测定梗死体积，要么冷冻用于使用放射自显影术测定缺血体积和脑血流量。
治疗组的血细胞比容在1.5小时时从（均值±标准误）46±1%降至35±2%（p < 0.01）。除栓塞组（治疗组和对照组）的缺血皮质外，皮质血流量在115 - 185 ml/min/100 g的正常范围内。治疗组的缺血体积和梗死体积分别比对照组减少了74%（p < 0.05）和89%（p < 0.05）。治疗组和假手术组的缺血和梗死体积无统计学差异。
这些数据表明，200/0.5羟乙基淀粉在早期给药时可能是缺血性中风的有效治疗方法，因为它将梗死体积和缺血体积从对照值降低到与假手术组无显著差异的水平。
