Department of Neurosurgery, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey.
Department of Neurosurgery, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey.
World Neurosurg. 2019 Dec;132:e443-e446. doi: 10.1016/j.wneu.2019.08.119. Epub 2019 Sep 5.
Cerebral vasospasm occurring after subarachnoid hemorrhage is a serious cause of morbidity. Cerebral vasospasm-related studies aim to prevent complications after subarachnoid hemorrhage. Nitric oxide affects brain blood flow and local vascular hemodynamics. L-arginine is used in the synthesis of nitric oxide, and hence we have investigated the efficacy of L-arginine treatment by using femoral artery vasospasm model.
Twenty-four male Sprague-Dawley rats have been divided into 3 groups as vasospasm, vasospasm + L-arginine, and control. In this study, we have preferred the "Rat Femoral Artery Vasospasm Model" described by Okada et al. Rats in the vasospasm + L-arginine group were given 300 mg/kg L-arginine for 7 days. At the end of the study, all samples of rat femoral arteries have been dissected and examined microscopically for histopathologic analysis. Statistical analysis was performed using Kruskal-Wallis and Mann-Whitney U tests, and P < 0.05 value was considered statistically significant.
L-arginine treatment reduced the morphometric changes such as irregularity of the elastic lamina, disruption of the endothelial cells, vacuolization, and hemorrhages that are caused by vasospasm. When the wall thickness and lumen diameter measurements were evaluated statistically, significant improvement was observed in the vasospasm + L-arginine group compared with the vasospasm group (P < 0.01).
In our study, the use of L-arginine, as a nitric oxide substrate, improved the experimental vasospasm in rats. Therefore we think that L-arginine therapy can be used in the prevention and treatment of cerebral vasospasm after subarachnoid hemorrhage.
蛛网膜下腔出血后发生的脑血管痉挛是一种严重的发病率原因。脑血管痉挛相关研究旨在预防蛛网膜下腔出血后的并发症。一氧化氮影响脑血流和局部血管血液动力学。精氨酸用于一氧化氮的合成,因此我们研究了使用股动脉血管痉挛模型的精氨酸治疗的疗效。
将 24 只雄性 Sprague-Dawley 大鼠分为血管痉挛、血管痉挛+精氨酸和对照组 3 组。在这项研究中,我们更喜欢 Okada 等人描述的“大鼠股动脉血管痉挛模型”。血管痉挛+精氨酸组的大鼠给予 300mg/kg 精氨酸 7 天。研究结束时,所有大鼠股动脉样本均进行解剖并进行组织病理学分析。使用 Kruskal-Wallis 和 Mann-Whitney U 检验进行统计分析,P < 0.05 被认为具有统计学意义。
精氨酸治疗减轻了由血管痉挛引起的弹性层不规则、内皮细胞破坏、空泡化和出血等形态学变化。当统计评估壁厚度和管腔直径测量值时,血管痉挛+精氨酸组与血管痉挛组相比,观察到显著改善(P < 0.01)。
在我们的研究中,使用作为一氧化氮底物的精氨酸改善了大鼠的实验性血管痉挛。因此,我们认为精氨酸治疗可用于预防和治疗蛛网膜下腔出血后的脑血管痉挛。