Moyer D J, Welsh F A, Zager E L
Division of Neurosurgery, University of Pennsylvania School of Medicine, Philadelphia.
Stroke. 1992 Dec;23(12):1812-6. doi: 10.1161/01.str.23.12.1812.
Brain temperature during ischemia is known to strongly influence the extent of cellular injury. The objectives of the present study were to determine the effect of severe focal ischemia on brain temperature and to assess the influence of those changes on focal infarction.
Severe focal ischemia was produced in rats using permanent occlusion of the distal middle cerebral artery combined with transient (60-minute) bilateral carotid artery occlusion. The temperature of the ischemic focus was measured with a small subdural probe. Three groups of rats were studied. In the first group, brain temperature was permitted to decline spontaneously to 32 degrees C after occlusion. In the second, brain temperature was maintained at 37.5 degrees C during occlusion. In the third group, the brain temperature was maintained at 37.5 degrees C for 40 minutes postocclusion before cooling. After recovery for 24 hours, the volume of infarction was measured in histological sections.
In the absence of cranial heating, the brain temperature fell to 33 degrees C by 10 minutes postocclusion, and infarct volume was 19 +/- 9 mm3 (mean +/- SEM; n = 6). Maintaining brain temperature at 37.5 degrees C increased the volume of infarction to 82 +/- 16 mm3 (n = 7; p < 0.001). Delayed cooling did not prevent the increase in infarct volume (75 +/- 16 mm3; n = 6).
These results demonstrate that in the present model of transient focal ischemia, spontaneous cooling of the brain during ischemia diminishes the extent of focal infarction, relative to that observed when cerebral hypothermia is prevented or delayed for 40 minutes.
已知缺血期间的脑温会强烈影响细胞损伤程度。本研究的目的是确定严重局灶性缺血对脑温的影响,并评估这些变化对局灶性梗死的影响。
采用大脑中动脉远端永久性闭塞联合双侧颈动脉短暂(60分钟)闭塞的方法在大鼠中制造严重局灶性缺血。用小型硬膜下探头测量缺血灶的温度。研究了三组大鼠。第一组,闭塞后允许脑温自发下降至32℃。第二组,闭塞期间将脑温维持在37.5℃。第三组,闭塞后40分钟将脑温维持在37.5℃,然后再进行降温。恢复24小时后,在组织学切片上测量梗死体积。
在无颅骨加热的情况下,闭塞后10分钟脑温降至33℃,梗死体积为19±9mm³(平均值±标准误;n = 6)。将脑温维持在37.5℃可使梗死体积增加至82±16mm³(n = 7;p < 0.001)。延迟降温并不能阻止梗死体积的增加(75±16mm³;n = 6)。
这些结果表明,在本短暂局灶性缺血模型中,与脑低温被阻止或延迟40分钟时相比,缺血期间脑的自发降温可减轻局灶性梗死的程度。