Nozaki K, Uemura Y, Okamoto S, Kikuchi H, Mizuno N
Department of Anatomy (1st Division), Faculty of Medicine, Kyoto University, Japan.
J Neurosurg. 1989 Oct;71(4):558-64. doi: 10.3171/jns.1989.71.4.0558.
This study examines the relaxant effect of calcitonin gene-related peptide (CGRP), a 37-amino acid peptide with a potent vasodilator action, on cerebral arterial spasm after subarachnoid hemorrhage (SAH). The spasm was induced by injecting autologous arterial blood percutaneously into the cisterna magna in adult mongrel dogs. The single-injection model of SAH was produced by injection of 1.0 ml/kg body weight of blood (on Day 0), and the double-injection model involved two successive injections of 0.5 ml/kg body weight of blood made 48 hours apart (on Day 0 and Day 2). On vertebral angiograms, arterial narrowing of the major cerebral arteries was most prominent on Day 3 after SAH in the single-injection model and on Day 7 in the double-injection model. When 10(-10) mol/kg of CGRP was administered intracisternally in the single-injection model on Day 3, the diameter of the spastic cerebral arteries, as determined by angiography, recovered to normal. After intracisternal administration of 10(-11) to 2 X 10(-10) mol/kg of CGRP on Day 7 in double-injection models, spastic cerebral arteries dilated in a dose-dependent manner. The dilatory effect of CGRP continued for a few hours after administration. The results suggest that CGRP injected intracisternally may reverse cerebral arterial spasm after SAH.
本研究探讨降钙素基因相关肽(CGRP)对蛛网膜下腔出血(SAH)后大脑动脉痉挛的舒张作用。CGRP是一种含37个氨基酸的肽,具有强大的血管舒张作用。通过经皮向成年杂种犬的小脑延髓池注射自体动脉血诱导痉挛。SAH单次注射模型是通过注射1.0 ml/kg体重的血液(第0天)产生的,双次注射模型则是间隔48小时连续两次注射0.5 ml/kg体重的血液(第0天和第2天)。在椎动脉血管造影上,单次注射模型中SAH后第3天大脑主要动脉的狭窄最为明显,双次注射模型中则在第7天最为明显。在单次注射模型中于第3天经小脑延髓池给予10^(-10) mol/kg的CGRP时,血管造影显示痉挛的大脑动脉直径恢复正常。在双次注射模型中于第7天经小脑延髓池给予10^(-11)至2×10^(-10) mol/kg的CGRP后,痉挛的大脑动脉以剂量依赖方式扩张。CGRP的舒张作用在给药后持续数小时。结果表明,经小脑延髓池注射CGRP可能逆转SAH后的大脑动脉痉挛。