Ginsberg M D, Prado R, Dietrich W D, Busto R, Watson B D
Stroke. 1987 May-Jun;18(3):570-4. doi: 10.1161/01.str.18.3.570.
Although hyperglycemia is known to exacerbate neuronal injury in the setting of reversible brain ischemia, its effect on irreversible thrombotic infarction is less well understood. In this study, unilateral thrombotic infarction was induced photochemically in the parietal cortex of Wistar rats. Seven days later, brains were perfusion-fixed for light microscopy. Infarct areas were measured by computer-assisted planimetry on multiple coronal sections at 250-micron intervals; these data were integrated to yield infarct volumes. Fasted, normoglycemic rats were compared with hyperglycemic rats that had received 1.2-1.5 ml of 50% dextrose i.p. 15 minutes prior to the induction of infarction. Infarct volume averaged 12.5 +/- 4.0 mm3 (mean +/- SD) in rats (n = 14) with plasma glucose levels of 72-184 mg/dl; this differed statistically from the average volume of 9.3 +/- 3.3 mm3 observed in rats (n = 13) with elevated plasma glucose (range 264-607 mg/dl). Spearman rank correlation analysis confirmed a significant correlation of larger infarct volumes with lower plasma glucose levels. In contrast, rats receiving mannitol i.p. to produce an osmotic load comparable with that of the dextrose-pretreated animals showed larger infarct volumes than saline-treated controls. The small but definite beneficial effect of hyperglycemia in this end-arteriolar thrombotic infarction model is possibly attributable to improved local energy metabolism at the periphery of the lesion during the early period of lesion expansion.
虽然已知高血糖会在可逆性脑缺血情况下加重神经元损伤,但其对不可逆性血栓性梗死的影响却了解较少。在本研究中,通过光化学法在Wistar大鼠顶叶皮质诱导单侧血栓性梗死。7天后,对大脑进行灌注固定以进行光学显微镜检查。通过计算机辅助平面测量法在间隔250微米的多个冠状切片上测量梗死面积;将这些数据整合以得出梗死体积。将禁食的血糖正常大鼠与在梗死诱导前15分钟腹腔注射1.2 - 1.5毫升50%葡萄糖的高血糖大鼠进行比较。血浆葡萄糖水平为72 - 184毫克/分升的大鼠(n = 14)梗死体积平均为12.5±4.0立方毫米(平均值±标准差);这与血浆葡萄糖升高(范围264 - 607毫克/分升)的大鼠(n = 13)观察到的平均体积9.3±3.3立方毫米在统计学上存在差异。Spearman等级相关分析证实梗死体积越大与血浆葡萄糖水平越低之间存在显著相关性。相比之下,腹腔注射甘露醇以产生与葡萄糖预处理动物相当的渗透负荷的大鼠,其梗死体积比生理盐水处理的对照组更大。在这个终末小动脉血栓性梗死模型中,高血糖虽小但明确的有益作用可能归因于在病变扩展早期病变周边局部能量代谢的改善。