Hakim A M, Shoubridge E A
McConnell Brain Imaging Center, Montreal Neurological Institute, Quebec, Canada.
Cerebrovasc Brain Metab Rev. 1989 Summer;1(2):115-32.
The discovery in the 1970s that hyperglycemia accompanying cerebral ischemia adversely affected survival led to a significant research effort on the biochemical, histological, and clinical consequences of cerebral acidosis. In this article, we review the methods used currently to measure cerebral pH and discuss the means the cell has to control its pH environment. We then discuss the influence of both normoglycemic and hyperglycemic cerebral ischemia on pH and conversely the effect of acidosis on cerebral blood flow (CBF), glycolysis, mitochondrial function, the blood-brain barrier, cellular volume control, the formation of cerebral edema, and the histological damage resulting from ischemia. We conclude with a discussion of how acidosis could worsen the derangement in calcium homeostasis known to occur as a consequence of ischemia, and review methods now available to counteract cerebral acidosis.
20世纪70年代发现，脑缺血伴发的高血糖对存活产生不利影响，这引发了对脑酸中毒的生化、组织学及临床后果的大量研究工作。在本文中，我们回顾了目前用于测量脑pH值的方法，并讨论细胞控制其pH环境的方式。然后，我们讨论了正常血糖和高血糖性脑缺血对pH值的影响，以及酸中毒对脑血流量（CBF）、糖酵解、线粒体功能、血脑屏障、细胞容积控制、脑水肿形成及缺血所致组织学损伤的影响。我们最后讨论酸中毒如何加重已知因缺血而发生的钙稳态紊乱，并回顾目前可用于对抗脑酸中毒的方法。
