Flamm E S, Ransohoff J
Surg Neurol. 1976 Oct;6(4):223-6.
Twelve patients with cerebral vasospasm following subarachnoid hemorrhage were treated with intravenous aminophylline and isoproterenol. After angiographic demonstration of spasm, all patients were begun on a continuous intravenous infusion of isoproterenol, 125 mug/hr, and aminophylline, 125 mg/hr, for a period of up to two weeks. The infusion was continued until there was clinical or angiographic evidence that spasm had diminished. Nine patients improved on this regimen and three remained unchanged. The use of isoproterenol and aminophylline is based on their effect on the enzymes responsible for the formation and degradation of cyclic adenosine monophosphate (cyclic AMP). An increase in cyclic AMP has been noted to produce relaxation of vascular smooth muscle. It is proposed that manipulation of these biochemical pathways may provide a method for influencing blood flow through cerebral vessels.
12例蛛网膜下腔出血后发生脑血管痉挛的患者接受了静脉注射氨茶碱和异丙肾上腺素治疗。在血管造影证实有痉挛后，所有患者开始持续静脉输注异丙肾上腺素（125微克/小时）和氨茶碱（125毫克/小时），持续两周。输注持续进行，直到有临床或血管造影证据表明痉挛已减轻。9例患者按此方案病情改善，3例无变化。使用异丙肾上腺素和氨茶碱是基于它们对负责环磷酸腺苷（cAMP）形成和降解的酶的作用。已注意到cAMP增加会使血管平滑肌松弛。有人提出，操纵这些生化途径可能提供一种影响脑血管血流的方法。
