Berger L, Hakim A M
McConnell Brain Imaging Center, Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, Quebec, Canada.
J Cereb Blood Flow Metab. 1989 Feb;9(1):58-64. doi: 10.1038/jcbfm.1989.8.
The effects of acute moderate hyperglycemia on local cerebral pH (LCpH) and local cerebral blood flow (LCBF) were studied in rats infused with glucose before middle cerebral artery (MCA) occlusion, and compared with findings in MCA occlusion alone. The effects of nimodipine infusion on LCBF and LCpH in MCA-occluded hyperglycemic rats were also studied. LCpH and LCBF were determined simultaneously by a double-label autoradiographic technique. Hyperglycemia was induced by an intraperitoneal injection of 2 g/kg D-glucose before MCA occlusion. Nimodipine-treated rats received the drug as an intravenous infusion of 0.5 micrograms/kg/min starting 15 min after occlusion, and ending at decapitation 4 h postocclusion. Cortical LCpH of five structures in the MCA territory of hyperglycemic rats varied between 6.64 +/- 0.04 and 6.72 +/- 0.02 (mean +/- SEM). These values were significantly lower than LCpH in the same ischemic structures in the control rats, which varied between 6.76 +/- 0.04 and 6.82 +/- 0.03 (p less than 0.05 for four of five structures). Cortical LCpH of hyperglycemic nimodipine-treated rats ranged between 6.94 +/- 0.02 and 7.05 +/- 0.02, indicating significant elevations in LCpH (p less than 0.001) compared with the untreated ischemic hyperglycemic animals. LCBF in the ischemic structures was not modified by hyperglycemia or nimodipine treatment. This suggests that nimodipine, by mechanisms other than improvement in blood flow, can prevent the enhanced cerebral tissue acidosis produced by hyperglycemia before incomplete focal ischemia.
在大脑中动脉(MCA)闭塞前输注葡萄糖的大鼠中,研究急性中度高血糖对局部脑pH值(LCpH)和局部脑血流量(LCBF)的影响,并与单纯MCA闭塞的结果进行比较。还研究了尼莫地平输注对MCA闭塞的高血糖大鼠LCBF和LCpH的影响。通过双标记放射自显影技术同时测定LCpH和LCBF。在MCA闭塞前通过腹腔注射2 g/kg D-葡萄糖诱导高血糖。尼莫地平治疗的大鼠在闭塞后15分钟开始以0.5微克/千克/分钟的静脉输注接受药物治疗,并在闭塞后4小时断头时结束。高血糖大鼠MCA区域五个结构的皮质LCpH在6.64±0.04至6.72±0.02之间变化(平均值±标准误)。这些值显著低于对照大鼠相同缺血结构中的LCpH,对照大鼠的LCpH在6.76±0.04至6.82±0.03之间变化(五个结构中的四个p<0.05)。尼莫地平治疗的高血糖大鼠的皮质LCpH在6.94±0.02至7.05±0.02之间,表明与未治疗的缺血性高血糖动物相比,LCpH显著升高(p<0.001)。高血糖或尼莫地平治疗未改变缺血结构中的LCBF。这表明尼莫地平通过血流改善以外的机制,可以在不完全局灶性缺血前预防高血糖引起的脑组织酸中毒加重。