激光多普勒血流仪在预测小鼠大脑中动脉腔内闭塞性卒中预后中的有效性
Validity of Laser Doppler Flowmetry in Predicting Outcome in Murine Intraluminal Middle Cerebral Artery Occlusion Stroke.
作者信息
Hedna Vishnumurthy Shushrutha, Ansari Saeed, Shahjouei Shima, Cai Peter Y, Ahmad Abdullah Shafique, Mocco J, Qureshi Adnan I
机构信息
Vishnumurthy Shushrutha Hedna and Saeed Ansari contributed equally to this work. ; Department of Neurology, University of Florida, Gainesville, FL 32611, USA.
Vishnumurthy Shushrutha Hedna and Saeed Ansari contributed equally to this work. ; Department of Neurology, University of Florida, Gainesville, FL 32611, USA ; Department of Surgery, University of Florida, Gainesville, FL 32611, USA.
出版信息
J Vasc Interv Neurol. 2015 Jul;8(3):74-82.
BACKGROUND
Laser Doppler flowmetry (LDF) can reliably reflect brain perfusion in experimental stroke by monitoring both the degree and the duration of relative regional cerebral blood flow (rCBF). Variation in rCBF was continuously monitored in 68 mice undergoing middle cerebral artery occlusion (MCAO) and 25 mice undergoing sham-operation and documented as LDF (%). Transcranial LDF changes in the territory of right middle cerebral artery during MCAO procedure were correlated with corrected infarct volume (CIV) and neurological deficit score (NDS).
METHODS
Ninety-three C57BL/6 mice (Harlan Laboratories, Indianapolis, IN) between 9 and 11 weeks old were randomly selected and assigned to either MCAO for 45 minutes (n = 68) or sham group (n = 25). Ischemia was induced using the transient intraluminal filament model of MCAO based on Koizumi's method and transcranial LDF was used to measure CBF during the procedure. Neurological deficits were measured at 2 and 23 hours after MCA reperfusion with NDS and 2% triphenyltetrazolium chloride (TTC) staining of carefully dissected brains was performed at 23 hours after reperfusion to determine infarct area.
RESULTS
After common carotid artery occlusion (CCAO), there was a negative association between LDF drop from base line and NDS at 2 hours (r = -0.43, P = 0.038) and 23 hours (r = -0.61, P = 0.003). Also, a negative correlation was noted between MCA reperfusion LDF and NDS at 23 hours (r = -0.53, P = 0.001). Moreover, post-MCA reperfusion LDF had a positive association with initial CCAO LDF (r = 0.761, P = 0.000) and MCA occlusion LDF (r = 0.31, P = 0.036) in predicting neurological outcome. NDS at 23 hours corresponded well with the infarct volume (r = 0.31, P = 0.005).
CONCLUSIONS
Greater augmentation of rCBF after MCA reperfusion was associated with improved neurological deficit scoring. Interestingly, greater reduction of regional cerebral blood flow after CCAO was also associated with improved neurological outcomes. The favorable neurological outcome is possibly due to interplay of factors such as vascular reserve, collaterals, and autoregulation mechanisms. We propose LDF changes as an additional noninvasive prognosticator of stroke outcome in the setting of experimental brain ischemia.
背景
激光多普勒血流仪（LDF）通过监测相对局部脑血流量（rCBF）的程度和持续时间，能够可靠地反映实验性中风中的脑灌注情况。对68只接受大脑中动脉闭塞（MCAO）的小鼠和25只接受假手术的小鼠的rCBF变化进行持续监测，并记录为LDF（%）。在MCAO手术过程中，右侧大脑中动脉区域的经颅LDF变化与校正梗死体积（CIV）和神经功能缺损评分（NDS）相关。
方法
随机选择93只9至11周龄的C57BL/6小鼠（Harlan Laboratories，印第安纳波利斯，印第安纳州），分为MCAO 45分钟组（n = 68）或假手术组（n = 25）。采用基于Koizumi方法的短暂性腔内丝线模型诱导缺血，并在手术过程中使用经颅LDF测量脑血流量。在MCA再灌注后2小时和23小时测量神经功能缺损，使用NDS进行评估，并在再灌注后23小时对仔细解剖的大脑进行2%氯化三苯基四氮唑（TTC）染色以确定梗死面积。
结果
在颈总动脉闭塞（CCAO）后，基线LDF下降与术后2小时（r = -0.43，P = 0.038）和23小时（r = -0.61，P = 0.003）的NDS呈负相关。此外，在23小时时，MCA再灌注LDF与NDS之间也存在负相关（r = -0.53，P = 0.001）。此外，在预测神经功能结局方面，MCA再灌注后LDF与初始CCAO LDF（r = 0.761，P = 0.000）和MCA闭塞LDF（r = 0.31，P = 0.036）呈正相关。23小时时的NDS与梗死体积具有良好的相关性（r = 0.31，P = 0.005）。
结论
MCA再灌注后rCBF的更大增加与神经功能缺损评分的改善相关。有趣的是，CCAO后局部脑血流量的更大减少也与神经功能结局的改善相关。良好的神经功能结局可能是由于血管储备、侧支循环和自动调节机制等因素的相互作用。我们提出LDF变化可作为实验性脑缺血情况下中风结局的一种额外的非侵入性预后指标。
Zotero 插件