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低剂量法舒地尔治疗慢性高血压合并急性缺血性卒中

Treatment with low dose fasudil for acute ischemic stroke in chronic hypertension.

作者信息

Chan Siu-Lung, Cipolla Marilyn J

机构信息

Departments of Neurological Sciences, Obstetrics, Gynecology & Reproductive Sciences, and Pharmacology, Larner, College of Medicine, University of Vermont, Burlington, VT, USA.

出版信息

J Cereb Blood Flow Metab. 2017 Sep;37(9):3262-3270. doi: 10.1177/0271678X17718665. Epub 2017 Jun 30.

Abstract

We investigated the effect of Rho kinase inhibition on changes in cerebral blood flow (CBF), brain injury and vascular function after ischemic stroke in spontaneously hypertensive rats (SHR). Changes in core MCA and collateral perfusion were measured by a validated laser Doppler method. Animals underwent 2 h tMCAO and 2 h reperfusion. Fasudil (0.1 mg/kg, i.v.) or vehicle was given at 30 min ischemia (n = 9/group; mean (SD)). Brain injury was determined by 2,3,5-triphenyltetrazolium chloride staining. To determine the effect of fasudil on vascular function, fasudil was given 10 min before reperfusion and parenchymal arterioles studied isolated (n = 6/group; mean(SD)). Collateral perfusion was low in vehicle-treated SHR (-8(32)%) that changed minimally with fasudil (6(24)%, p > 0.05, effect size: 0.47;95% CI-0.49-1.39). Reperfusion CBF was below baseline in vehicle (-27(26)%) and fasudil (-32(25)%, p > 0.05, effect size: 0.19; 95% CI-0.74-1.11) groups, suggesting incomplete reperfusion in both groups. Fasudil had little effect on brain injury volume (28(13)% vs. 36(7)% in vehicle, p > 0.05, effect size: 0.75; 95% CI-0.24-1.66). In isolated parenchymal arterioles, myogenic tone was similar between groups (37(6)% vs. 38(10)% in vehicle, p > 0.05, effect size: 0.09; 95% CI-1.05-1.21). There were no differences with fasudil treatment vs. vehicle in perfusion, brain injury and vascular function that may be related to the low dose that had minimal blood pressure lowering effect.

摘要

我们研究了Rho激酶抑制对自发性高血压大鼠(SHR)缺血性中风后脑血流量(CBF)变化、脑损伤和血管功能的影响。采用经过验证的激光多普勒方法测量大脑中动脉核心区和侧支灌注的变化。动物接受2小时的大脑中动脉闭塞(tMCAO)和2小时的再灌注。在缺血30分钟时给予法舒地尔(0.1mg/kg,静脉注射)或赋形剂(每组n = 9;均值(标准差))。通过2,3,5-氯化三苯基四氮唑染色确定脑损伤情况。为了确定法舒地尔对血管功能的影响,在再灌注前10分钟给予法舒地尔,并对分离的实质小动脉进行研究(每组n = 6;均值(标准差))。赋形剂处理的SHR侧支灌注较低(-8(32)%),使用法舒地尔治疗后变化极小(6(24)%,p > 0.05,效应大小:0.47;95%置信区间-0.49至1.39)。赋形剂组(-27(26)%)和法舒地尔组(-32(25)%,p > 0.

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