Combs D J, Dempsey R J, Kumar S, Donaldson D
Department of Surgery, University of Kentucky, Lexington 40536.
Metab Brain Dis. 1990 Dec;5(4):169-78. doi: 10.1007/BF00997070.
Although it has been well established that hyperglycemia increases cerebral damage following transient cerebral ischemia, its effect on permanent focal ischemia is controversial. We hypothesized that other factors associated with hyperglycemia, such as plasma insulin, may alter the brain's response to hyperglycemia. The objective of this study was to determine if hyperglycemia changes infarction size following 8 hr of middle cerebral artery occlusion in the anesthetized cat and to examine if changes in plasma insulin levels alter hyperglycemia's effects. Infarct size in hyperglycemic cats with increased plasma insulin (38.3 +/- 8.4, mean +/- SE) or in hyperglycemic cats without increased plasma insulin (30.5 +/- 7.6%) was not significantly different from that of ischemic controls (33.8 +/- 2.8%). However, the variability in infarct size tended to be greater (P = 0.0647) among all hyperglycemic cats compared to control animals. The source of the variability is unknown, but this observation is dependent on the exact nature of the focal ischemic insult (i.e., degree of collateral blood supply) and that this effect may vary greatly from individual to individual within a population.
尽管高血糖会在短暂性脑缺血后增加脑损伤这一点已得到充分证实，但其对永久性局灶性缺血的影响仍存在争议。我们推测，与高血糖相关的其他因素，如血浆胰岛素，可能会改变大脑对高血糖的反应。本研究的目的是确定高血糖是否会改变麻醉猫大脑中动脉闭塞8小时后的梗死面积，并研究血浆胰岛素水平的变化是否会改变高血糖的作用。血浆胰岛素升高的高血糖猫（38.3±8.4，平均值±标准误）或血浆胰岛素未升高的高血糖猫（30.5±7.6%）的梗死面积与缺血对照组（33.8±2.8%）相比无显著差异。然而，与对照动物相比，所有高血糖猫的梗死面积变异性往往更大（P = 0.0647）。变异性的来源尚不清楚，但这一观察结果取决于局灶性缺血损伤的确切性质（即侧支血供程度），并且这种影响在人群中的个体之间可能差异很大。
