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全脑缺血后的局部脑葡萄糖代谢:用氟碳乳剂经脑室池灌注治疗

Local cerebral glucose metabolism after global ischemia: treatment by ventriculocisternal perfusion with a fluorocarbon emulsion.

作者信息

Triolo A J, Osterholm J L, Alexander G M, Bell R D, Frazer G D

机构信息

Department of Pharmacology, Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania.

出版信息

Neurosurgery. 1990 Mar;26(3):480-7; discussion 487-8.

PMID:2320217
Abstract

The local cerebral metabolic rate for glucose (LCMRg) was measured in cats subjected to global cerebral ischemia (GCI). Control (nonperfused) cats showed decreased LCMRg (P less than 0.01) in the frontal, temporal, parietal, and occipital cortex 9.5 hours after a 10-minute exposure to GCI. Cats perfused ventriculocisternally with oxygenated nutrient solution (ONS) for 8 hours showed significant increases in the LCMRg (p less than 0.05) at 9.5 hours postischemia in the parietal and occipital areas over the levels found in untreated ischemic cats. Supplementing the ONS perfusion medium with fluorocarbon (OFNS) increased the LCMRg (P less than 0.05) in the frontal, as well as the parietal and occipital areas, over that seen in untreated ischemic brains. The increase of LCMRg in three (rather than only two) cortical areas may be a result of the ability of the fluorocarbon in OFNS to deliver greater quantities of oxygen to the brain than ONS without fluorocarbon. Perfusion with OFNS without glucose, or with low (50 mg%) glucose, was more effective than OFNS with high (200 mg%) glucose in restoring LCMRg to normal in all four cortical areas affected by GCI. In five brain areas not affected by GCI, perfusion with OFNS having no glucose significantly increased LCMRg as compared to normal animals. This study demonstrates that OFNS perfused by the ventriculocisternal route can restore toward normal the LCMRg following GCI and that different concentrations of glucose in the perfusing fluid will have variable effects on LCMRg in certain brain areas.

摘要

对遭受全脑缺血(GCI)的猫进行了局部脑葡萄糖代谢率(LCMRg)的测量。对照(未灌注)猫在暴露于GCI 10分钟后9.5小时,额叶、颞叶、顶叶和枕叶皮质的LCMRg降低(P小于0.01)。用含氧营养液(ONS)脑室池灌注8小时的猫,在缺血后9.5小时,顶叶和枕叶区域的LCMRg较未治疗的缺血猫显著增加(p小于0.05)。在ONS灌注介质中添加氟碳化合物(OFNS),额叶以及顶叶和枕叶区域的LCMRg比未治疗的缺血脑有所增加(P小于0.05)。三个(而非仅两个)皮质区域LCMRg的增加可能是由于OFNS中的氟碳化合物比不含氟碳化合物的ONS能够向大脑输送更多氧气。在受GCI影响的所有四个皮质区域,用不含葡萄糖的OFNS或低(50mg%)葡萄糖的OFNS灌注比高(200mg%)葡萄糖的OFNS更有效地将LCMRg恢复至正常。在五个未受GCI影响的脑区,与正常动物相比,用不含葡萄糖的OFNS灌注显著增加了LCMRg。本研究表明,通过脑室池途径灌注OFNS可使GCI后的LCMRg恢复正常,且灌注液中不同浓度的葡萄糖对某些脑区的LCMRg会产生不同影响。

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