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尼可地尔通过一氧化氮途径和使小鼠体内ATP敏感性钾通道开放来增加脑血流量。

Nicorandil increased the cerebral blood flow via nitric oxide pathway and ATP-sensitive potassium channel opening in mice.

作者信息

Kotoda Masakazu, Ishiyama Tadahiko, Mitsui Kazuha, Hishiyama Sohei, Matsukawa Takashi

机构信息

Department of Anesthesiology, Faculty of Medicine, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi, 409-3898, Japan.

Surgical Center, University of Yamanashi Hospital, University of Yamanashi, Chuo, Yamanashi, Japan.

出版信息

J Anesth. 2018 Apr;32(2):244-249. doi: 10.1007/s00540-018-2471-2. Epub 2018 Mar 5.

Abstract

PURPOSE

Nicorandil has dual properties and acts as a nitric oxide donor and an ATP-sensitive potassium (K) channel opener. Considering its pharmacological profile, nicorandil might exert protective effects on the brain as well as on the heart. The purpose of this study was to directly evaluate the effect of nicorandil on cerebral blood flow (CBF) in mice using a transcranial Doppler method.

METHODS

Under general anesthesia, the nicorandil groups received a single-bolus intraperitoneal injection of the respective doses of nicorandil (1, 5, or 10 mg/kg), while the control group received vehicle only. CBF was measured using a transcranial Doppler flowmeter. N-nitro-L-arginine methyl ester and glibenclamide were used to elucidate the underlying mechanisms.

RESULTS

A single-bolus injection of 1 mg/kg of nicorandil increased the CBF (11.6 ± 3.6 vs. 0.5 ± 0.7%, p < 0.001) without affecting the heart rate and blood pressure. On the contrary, 5 and 10 mg/kg of nicorandil significantly decreased the cerebral blood flow by decreasing the mean blood pressure below the cerebral autoregulation range. The positive effect of 1 mg/kg of nicorandil on the cerebral blood flow was inhibited by co-administration of either N-nitro-L-arginine methyl ester or glibenclamide.

CONCLUSIONS

A clinical dose of nicorandil increases CBF without affecting systemic hemodynamics. The positive effect of nicorandil on CBF is most likely caused via both the nitric oxide pathway and K channel opening.

摘要

目的

尼可地尔具有双重特性,可作为一氧化氮供体和三磷酸腺苷敏感性钾(K)通道开放剂。鉴于其药理学特性,尼可地尔可能对大脑和心脏均具有保护作用。本研究的目的是使用经颅多普勒方法直接评估尼可地尔对小鼠脑血流量(CBF)的影响。

方法

在全身麻醉下,尼可地尔组分别接受单次腹腔注射相应剂量的尼可地尔(1、5或10mg/kg),而对照组仅接受赋形剂。使用经颅多普勒流量计测量CBF。使用N-硝基-L-精氨酸甲酯和格列本脲来阐明潜在机制。

结果

单次注射1mg/kg的尼可地尔可增加CBF(11.6±3.6对0.5±0.7%,p<0.001),且不影响心率和血压。相反,5和10mg/kg的尼可地尔通过将平均血压降低至脑自动调节范围以下而显著降低脑血流量。同时给予N-硝基-L-精氨酸甲酯或格列本脲可抑制1mg/kg尼可地尔对脑血流量的积极作用。

结论

临床剂量的尼可地尔可增加CBF,而不影响全身血流动力学。尼可地尔对CBF的积极作用很可能是通过一氧化氮途径和钾通道开放共同引起的。

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