Salgado A V, Jones S C, Furlan A J, Korfali E, Marshall S A, Little J R
Department of Neurology, Cleveland Clinic Foundation, OH 44195-5070.
Ann Neurol. 1989 Nov;26(5):621-7. doi: 10.1002/ana.410260506.
We compared the effects of intravenous treatment with combined low-molecular-weight dextran and nimodipine (n = 9), or placebo (n = 10), on local cerebral blood flow after occlusion of the left middle cerebral and common carotid artery in the rat. Treatment for a total of 4 hours with low-molecular-weight dextran (5 mg/kg/min) and nimodipine (0.25 microgram/kg/min) produced a decrease in hematocrit from 46 +/- 1 to 33 +/- 1% at the end of the study and a statistically significant increase in local cerebral blood flow, when compared to the control group, in 6 regions of interest: the territories of the right middle (p = 0.01), right anterior (p = 0.007), and left anterior cerebral arteries (p = 0.001); the superior (p = 0.03) and inferior border zone (p = 0.003); and white matter in the right hemisphere (p = 0.04). The ischemic volume, defined as brain volume with a cerebral blood flow of less than the critical level of 25 ml/min/100 gm was determined as a percentage of total brain volume for the control and treatment groups. The group treated with low-molecular-weight dextran and nimodipine showed a 31% decrease in ischemic volume (p = 0.03). These results indicate that a bimodal approach with low-molecular-weight dextran and nimodipine can be safely used in a model of acute stroke and has a beneficial effect on local cerebral blood flow and ischemic volume when compared with control subjects. After 4 hours, the potential exists that this treatment is therapeutic, assuming that the ischemic volume progresses to infarction.
我们比较了静脉注射低分子量右旋糖酐和尼莫地平联合用药（n = 9）或安慰剂（n = 10）对大鼠左大脑中动脉和颈总动脉闭塞后局部脑血流的影响。用低分子量右旋糖酐（5毫克/千克/分钟）和尼莫地平（0.25微克/千克/分钟）共治疗4小时，研究结束时血细胞比容从46±1%降至33±1%，与对照组相比，在6个感兴趣区域局部脑血流有统计学显著增加：右大脑中动脉（p = 0.01）、右大脑前动脉（p = 0.007）和左大脑前动脉供血区（p = 0.001）；大脑上缘区（p = 0.03）和下缘区（p = 0.003）；以及右半球白质（p = 0.04）。将脑血流低于25毫升/分钟/100克临界水平的脑体积定义为缺血体积，并确定为对照组和治疗组总脑体积的百分比。低分子量右旋糖酐和尼莫地平治疗组的缺血体积减少了31%（p = 0.03）。这些结果表明，低分子量右旋糖酐和尼莫地平的双峰治疗方法可安全用于急性中风模型，与对照组相比，对局部脑血流和缺血体积有有益影响。4小时后，如果缺血体积进展为梗死，这种治疗有可能具有治疗作用。
