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实验性脑出血:自发性肿块病变形成后血流动力学变化的进展

Experimental intracerebral hemorrhage: progression of hemodynamic changes after production of a spontaneous mass lesion.

作者信息

Nehls D G, Mendelow A D, Graham D I, Sinar E J, Teasdale G M

机构信息

Department of Neurosurgery, University of Glasgow, Scotland.

出版信息

Neurosurgery. 1988 Oct;23(4):439-44. doi: 10.1227/00006123-198810000-00006.

Abstract

The aim of the study was to determine whether the extent of ischemia produced by an experimental space-occupying lesion changed between 5 minutes and 4 hours after the production of a lesion. In two groups of rats, a 50-microliter balloon was inflated in the right caudate nucleus. Cerebral blood flow (CBF) was determined by 14C-iodoantipyrine quantitative autoradiography, in Group 1 (n = 6) 5 minutes after inflation and in Group 2 (n = 6) 4 hours later. After 5 minutes of inflation, the mean blood flow in the caudate nucleus was reduced to 65% of the contralateral value and 11.5% of the ipsilateral caudate nucleus had a blood flow of below 25 ml/100 g/minute. After 4 hours of inflation, there was a greater fall in the mean CBF of the ipsilateral caudate nucleus to 30% of the contralateral value, and 38.9% of the ipsilateral caudate nucleus had a CBF of less than 25 ml/100 g/minute. The differences between the two groups were significant (mean CBF, P less than 0.01; CBF less than 25 ml/100 g/minute, P less than 0.02). The results show that the initial ischemic lesion produced by a spontaneous intracerebral space-occupying lesion does not remain static, but progresses with time and is significantly greater after 4 hours than after 5 minutes. Interventions that reduce the progression of ischemia may be beneficial in reducing the ultimate amount of ischemic brain damage.

摘要

本研究的目的是确定实验性占位性病变所产生的缺血程度在病变形成后5分钟至4小时之间是否发生变化。在两组大鼠中,将一个50微升的球囊在右侧尾状核中充气。通过14C-碘安替比林定量放射自显影法测定脑血流量(CBF),第1组(n = 6)在充气后5分钟测定,第2组(n = 6)在4小时后测定。充气5分钟后,尾状核的平均血流量降至对侧值的65%,同侧尾状核中有11.5%的血流量低于25毫升/100克/分钟。充气4小时后,同侧尾状核的平均CBF进一步下降至对侧值的30%,同侧尾状核中有38.9%的CBF小于25毫升/100克/分钟。两组之间的差异具有显著性(平均CBF,P < 0.01;CBF小于25毫升/100克/分钟,P < 0.02)。结果表明,自发性脑内占位性病变所产生的初始缺血性病变并非静止不变,而是随时间进展,4小时后的病变明显大于5分钟后的病变。减少缺血进展的干预措施可能有助于减少最终的缺血性脑损伤量。

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