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自由基清除剂依达拉奉可改善急性脑出血后的神经功能和血肿周围葡萄糖代谢。

The radical scavenger edaravone improves neurologic function and perihematomal glucose metabolism after acute intracerebral hemorrhage.

作者信息

Shang Hanbing, Cui Derong, Yang Dehua, Liang Sheng, Zhang Weifeng, Zhao Weiguo

机构信息

Department of Neurosurgery, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Department of Anesthesiology, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

出版信息

J Stroke Cerebrovasc Dis. 2015 Jan;24(1):215-22. doi: 10.1016/j.jstrokecerebrovasdis.2014.08.021. Epub 2014 Nov 12.

Abstract

Oxidative injury caused by reactive oxygen species plays an important role in the progression of intracerebral hemorrhage (ICH)-induced secondary brain injury. Previous studies have demonstrated that the free radical scavenger edaravone may prevent neuronal injury and brain edema after ICH. However, the influence of edaravone on cerebral metabolism in the early stages after ICH and the underlying mechanism have not been fully investigated. In the present study, we investigated the effect of edaravone on perihematomal glucose metabolism using (18)F-fluorordeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT). Additionally, the neurologic deficits, brain edemas, and cell death that followed ICH were quantitatively analyzed. After blood infusion, the rats treated with edaravone showed significant improvement in both forelimb placing and corner turn tests compared with those treated with vehicle. Moreover, the brain water content of the edaravone-treated group was significantly decreased compared with that of the vehicle group on day 3 after ICH. PET/CT images of ICH rats exhibited obvious decreases in FDG standardized uptake values in perihematomal region on day 3, and the lesion-to-normal ratio of the edaravone-treated ICH rats was significantly increased compared with that of the control rats. Calculation of the brain injury volumes from the PET/CT images revealed that the volumes of the blood-induced injuries were significantly smaller in the edaravone group compared with the vehicle group. Terminal Deoxynucleotidyl Transferase-mediated dUTP Nick End Labeling assays performed 3 days after ICH revealed that the numbers of apoptotic cells in perihematomal region of edaravone-treated ICH rats were decreased relative to the vehicle group. Thus, the present study demonstrates that edaravone has scavenging properties that attenuate neurologic behavioral deficits and brain edema in the early period of ICH. Additionally, edaravone may improve cerebral metabolism around the hematoma by attenuating apoptotic cell death after ICH.

摘要

活性氧引起的氧化损伤在脑出血(ICH)所致继发性脑损伤的进展中起重要作用。先前的研究表明,自由基清除剂依达拉奉可能预防ICH后的神经元损伤和脑水肿。然而,依达拉奉对ICH后早期脑代谢的影响及其潜在机制尚未得到充分研究。在本研究中,我们使用(18)F-氟脱氧葡萄糖(FDG)正电子发射断层扫描/计算机断层扫描(PET/CT)研究了依达拉奉对血肿周围葡萄糖代谢的影响。此外,对ICH后出现的神经功能缺损、脑水肿和细胞死亡进行了定量分析。注入血液后,与给予赋形剂的大鼠相比,给予依达拉奉的大鼠在前肢放置和转角试验中均有显著改善。此外,在ICH后第3天,依达拉奉治疗组的脑含水量与赋形剂组相比显著降低。ICH大鼠的PET/CT图像显示,在第3天血肿周围区域的FDG标准化摄取值明显降低,与对照大鼠相比,依达拉奉治疗的ICH大鼠的病变与正常比值显著增加。根据PET/CT图像计算脑损伤体积,结果显示依达拉奉组血液诱导损伤的体积明显小于赋形剂组。ICH后3天进行的末端脱氧核苷酸转移酶介导的dUTP缺口末端标记分析显示,与赋形剂组相比,依达拉奉治疗的ICH大鼠血肿周围区域的凋亡细胞数量减少。因此,本研究表明依达拉奉具有清除特性,可减轻ICH早期的神经行为缺损和脑水肿。此外,依达拉奉可能通过减轻ICH后的凋亡细胞死亡来改善血肿周围的脑代谢。

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