Inglis F, Kuroda Y, Bullock R
Department of Neurosurgery, University of Glasgow, Scotland.
J Neurotrauma. 1992 Summer;9(2):75-84. doi: 10.1089/neu.1992.9.75.
Intracranial hematomas occur in almost half of patients who sustain a severe head injury, and outcome is particularly poor in patients with acute subdural hematoma. We have measured regional cerebral glucose metabolism (2-deoxyglucose autoradiography) in a new rat model of acute subdural hematoma and compared the changes to those seen in sham-operated control animals and animals pretreated with a high-affinity competitive NMDA antagonist, D-CPP-ene. At 2 h after inducing the hematoma, a severe reduction in glucose use was seen in the cortex beneath the hematoma (less than 5 mumol/100g/min) consistent with a zone of histologic infarction seen in other studies. A band of markedly increased glucose use was seen in the periischemic zone, surrounding this infarcted tissue and throughout the hippocampus bilaterally (up to 142% increase). Both the zone of reduced glucose use and the volume of tissue with increased glucose metabolism were significantly reduced in the animals pretreated with D-CPP-ene. These data indicate that the neuroprotective effect of NMDA antagonists, seen in this and other models, may be mediated by reducing the increased metabolism that occurs probably due to glutamate release.
在遭受严重头部损伤的患者中，近半数会发生颅内血肿，而急性硬膜下血肿患者的预后尤其差。我们在一种新的急性硬膜下血肿大鼠模型中测量了局部脑葡萄糖代谢（2-脱氧葡萄糖放射自显影），并将这些变化与假手术对照动物以及用高亲和力竞争性NMDA拮抗剂D-CPP-ene预处理的动物所观察到的变化进行了比较。在诱导血肿后2小时，血肿下方的皮质中葡萄糖利用严重减少（低于5微摩尔/100克/分钟），这与其他研究中所见的组织学梗死区域一致。在缺血周边区可见葡萄糖利用明显增加的一条带，围绕着这个梗死组织并双侧贯穿整个海马体（增加高达142%）。在用D-CPP-ene预处理的动物中，葡萄糖利用减少的区域以及葡萄糖代谢增加的组织体积均显著减小。这些数据表明，在本模型和其他模型中所见的NMDA拮抗剂的神经保护作用可能是通过减少可能由于谷氨酸释放而发生的代谢增加来介导的。
