Auer L M, Pfurtscheller G, Abobaker S, Ott E, Marguc K J, Lechner H
Department of Neurosurgery, University of Graz, Austria.
Neurol Res. 1988 Dec;10(4):246-51. doi: 10.1080/01616412.1988.11739850.
In a series of 13 patients with cerebrovascular occlusive disease regional cerebral blood flow (rCBF) measurements (two-dimensional intravenous 133Xe clearance method) and quantitative EEG analysis (sensorimotor rhythms) as well as electronic measurement of handforce were performed before and during intravenous infusion of 1 microgram kg/min of one of the lipophilic dihydropyridine calcium channel blocker nimodipine (Nimotop). The aim of the study was to test the hypothesis of the existence of hypoperfusion (ischaemic penumbra) in the surroundings of chronic cerebral infarcts. All 3 parameters improved in one patient. Sensorimotor rhythms increased in 5 patients, rCBF in 3. EEG and rCBF improved in 2 patients. In 3 instances, a redistribution of rCBF in favour of the peri-infarct zone was noted (significant increase of rCBF from 35 +/- 2 SEM to 53 +/- 4 ml/100 g/min (p less than 0.01), whereas rCBF fell from 61 +/- 5 to 46 +/- 2 ml/100 g/min on a collimator remote from the infarct but in the infarcted hemisphere. The parallel improvement of rCBF and EEG in brain regions surrounding chronic infarcts in 3 patients was interpreted as functional improvement as a consequence of nimodipine-induced normalization of peri-infarct hypoperfusion, i.e. reversal of flow-dependent neuronal silence and/or dysfunction.
在一组13例脑血管闭塞性疾病患者中，在静脉输注亲脂性二氢吡啶类钙通道阻滞剂尼莫地平（尼莫通），速率为1微克/千克/分钟之前和期间，进行了局部脑血流量（rCBF）测量（二维静脉注射133Xe清除法）、定量脑电图分析（感觉运动节律）以及手部力量的电子测量。该研究的目的是检验慢性脑梗死周围存在灌注不足（缺血半暗带）这一假说。1例患者的所有3项参数均有改善。5例患者的感觉运动节律增加，3例患者的rCBF增加。2例患者的脑电图和rCBF有所改善。在3例中，注意到rCBF重新分布有利于梗死周边区（rCBF从35±2标准误显著增加至53±4毫升/100克/分钟（p＜0.01），而在远离梗死灶但在梗死半球的准直器上，rCBF从61±5降至46±2毫升/100克/分钟）。3例患者慢性梗死灶周围脑区rCBF和脑电图的平行改善被解释为尼莫地平诱导梗死周边灌注不足正常化的结果，即血流依赖性神经元静息和/或功能障碍的逆转，从而导致功能改善。
