Sakaki S, Ohue S, Kohno K, Takeda S
Department of Neurological Surgery, Ehime University School of Medicine, Japan.
Neurosurgery. 1989 Nov;25(5):753-61. doi: 10.1097/00006123-198911000-00010.
We examined vascular reactivity to various vasoconstrictors and dilators, and the changes in calcium-calmodulin levels in canine basilar arteries after subarachnoid hemorrhage (SAH). Contractile responses to noradrenaline, serotonin, and potassium chloride were markedly attenuated at 48 hours (P less than 0.05), and further attenuated at 7 and 14 days after SAH (P less than 0.01). Dilation responses to calcium antagonist were maintained at 48 hours after SAH, but were markedly reduced at 7 and 14 days after SAH (P less than 0.05). Transmission electron micrographs of the basilar artery showed contraction of the media between 48 hours and 7 days and degeneration of smooth muscle cells over the 7 days after SAH. Electron microscopic cytochemical examination for calcium showed that intracellular deposits of calcium pyroantimonate increased in smooth muscle cells of basilar arteries at 1 hour after the first intracisternal injection of blood (early spasm), but decreased in smooth muscle cells at 48 hours after SAH (at the beginning of delayed vasospasm). They decreased further in the vessels 7 days after SAH. The calmodulin contents in the basilar arteries were decreased slightly at 6 hours, and significantly (P less than 0.05) at 48 hours after SAH, as determined by radioimmunoassay and phosphodiesterase assay. Therefore, it is considered that delayed vasospasm is not simply an active contraction of the vessels, but a functional or structural derangement of contractile elements of smooth muscle cells after 48 hours after SAH.
我们研究了犬蛛网膜下腔出血(SAH)后基底动脉对各种血管收缩剂和扩张剂的血管反应性,以及钙调蛋白水平的变化。对去甲肾上腺素、5-羟色胺和氯化钾的收缩反应在48小时时显著减弱(P<0.05),在SAH后7天和14天进一步减弱(P<0.01)。对钙拮抗剂的舒张反应在SAH后48小时时保持,但在SAH后7天和14天显著降低(P<0.05)。基底动脉的透射电子显微镜图像显示,在SAH后48小时至7天内中膜收缩,7天内平滑肌细胞退变。钙的电子显微镜细胞化学检查显示,在首次脑池内注射血液后1小时(早期痉挛),基底动脉平滑肌细胞内焦锑酸钙沉积增加,但在SAH后48小时(延迟性血管痉挛开始时)平滑肌细胞内焦锑酸钙沉积减少。在SAH后7天,血管内的焦锑酸钙沉积进一步减少。通过放射免疫测定和磷酸二酯酶测定法确定,基底动脉中的钙调蛋白含量在SAH后6小时略有下降,在48小时时显著下降(P<0.05)。因此,认为延迟性血管痉挛并非简单的血管主动收缩,而是SAH后48小时后平滑肌细胞收缩成分的功能或结构紊乱。