Yuan X Q, Prough D S, Smith T L, Dewitt D S
Department of Anesthesia, Bowman Gray School of Medicine, Wake Forest University Medical Center, Winston-Salem, North Carolina.
J Neurotrauma. 1988;5(4):289-301. doi: 10.1089/neu.1988.5.289.
Alterations in cerebral blood flow (CBF) are among the most important secondary pathophysiologic consequences of traumatic brain injury. The present study compared CBF in control rats (n = 20) and in rats that received a calibrated experimental traumatic brain injury (n = 17). The traumatized rats were anesthetized with ketamine (25 mg/kg) and xylazine (10 mg/kg), and prepared for fluid percussion injury (FPI). Twenty-four hours later, the rats were anesthetized with 1% halothane in nitrous oxide-oxygen (70:30) and the left atrium was catheterized via a thoroacotomy. The atrial cannula was used to inject 15 microns radiolabeled microspheres to measure CBF. Following surgery, the concentration of halothane was reduced to 0.5% and the rats were paralyzed with pancuronium bromide (0.1 mg/kg). Thirty minutes later, baseline microsphere determinations were made, and the rats were injured (2.47 +/- 0.08 atm). Each rat received additional injections of microspheres at two of the following four times (T): 5, 15, 30, and 60 min after the brain injury. The procedures for the control group rats were the same as described above except that the rats were not subjected to the craniotomy and the FPI. The traumatized group exhibited heterogeneous decreases in CBF following trauma. Global CBF in this group was 78% (p less than 0.01), 64% (p less than 0.05), 52% (p less than 0.001) of those in the control group at T5, 15, 30, and 60, respectively. In rats, the most prominent cerebral circulatory changes following fluid percussion injury were early reductions of CBF and an increasingly heterogeneous CBF pattern. Hemorrhage, edema, and elevated prostagandin levels are mechanisms that may contribute to these changes.
脑血流量(CBF)的改变是创伤性脑损伤最重要的继发性病理生理后果之一。本研究比较了对照组大鼠(n = 20)和接受校准实验性创伤性脑损伤的大鼠(n = 17)的脑血流量。创伤大鼠用氯胺酮(25 mg/kg)和赛拉嗪(10 mg/kg)麻醉,并准备进行液压冲击伤(FPI)。24小时后,大鼠用1%氟烷在氧化亚氮-氧气(70:30)中麻醉,通过胸廓切开术将左心房插管。心房插管用于注射15微米放射性标记微球以测量脑血流量。手术后,氟烷浓度降至0.5%,大鼠用潘库溴铵(0.1 mg/kg)麻痹。30分钟后,进行基线微球测定,然后大鼠受伤(2.47±0.08 atm)。每只大鼠在脑损伤后的以下四个时间点(T)中的两个时间点额外注射微球:5、15、30和60分钟。对照组大鼠的操作与上述相同,只是大鼠未进行开颅手术和FPI。创伤组在创伤后出现脑血流量异质性下降。该组在T5、15、30和60时的全脑血流量分别为对照组的78%(p<0.01)、64%(p<0.05)、52%(p<0.001)。在大鼠中,液压冲击伤后最显著的脑循环变化是脑血流量早期减少和脑血流量模式越来越不均匀。出血、水肿和前列腺素水平升高是可能导致这些变化的机制。