Korosue K, Izawa I, Hamano S, Ishida K, Kurihara E, Nagao T, Tamaki N, Matsumoto S
Department of Neurosurgery, Nagao Hospital, Koh-chi, Japan.
No Shinkei Geka. 1987 Jun;15(6):635-40.
Prostaglandin (PG) E1 is a potent vasodilator on the peripheral vessels and also has an inhibitory action of platelet aggregation. Thus it is expected that PGE1 may be used for the treatment of cerebral vasospasm in aneurysmal subarachnoid hemorrhage. Lipo-PGE1, the lipid emulsified PGE1, is not destroyed in the lung, has much longer half life in the circulation than PGE1 which is rapidly inactivated in the lung. The effects of intravenous injection of lipo-PGE1 on the cerebral hemodynamics and the central conduction time (CCT) of the sensory evoked potential under vasospastic conditions has been studied in eight patients. All these 8 patients demonstrated severe angiographic vasospasm and signs of cerebral ischemia. The 15-20 micrograms of lipo-PGE1 was administered every eight hours for 5 to 7 days. Within 6 hours of the first lipo-PGE1 treatment, the regional cerebral blood flow (rCBF) and the CCT measurements were reported to document the effect of treatment. The average pretreatment of rCBF on the right anterior, middle and posterior cerebral artery were 46.6 +/- 6.8, 56.4 +/- 7.3 and 58.8 +/- 8.9 ml/100 g/min and on the left side were 52.1 +/- 9.2, 49.1 +/- 10.8 and 56.1 +/- 9.2 ml/100 g/min respectively. With treatment these flows increased to 53.0 +/- 6.9, 64.3 +/- 5.3 and 63.0 +/- 4.6 ml/100 g/min respectively on the right side and 60.8 +/- 9.4, 60.6 +/- 9.7 and 60.6 +/- 7.2 ml/100 g/min respectively on the left. The CCT also demonstrated the improvement from 6.36 msec to 6.21 msec by the initial PGE1 treatment.(ABSTRACT TRUNCATED AT 250 WORDS)
前列腺素（PG）E1是一种强效的外周血管扩张剂，对血小板聚集也有抑制作用。因此，人们期望PGE1可用于治疗动脉瘤性蛛网膜下腔出血后的脑血管痉挛。脂微球前列腺素E1（Lipo-PGE1）是脂质乳化的PGE1，在肺内不会被破坏，在循环中的半衰期比在肺内迅速失活的PGE1长得多。研究人员对8例患者在血管痉挛状态下静脉注射Lipo-PGE1对脑血流动力学和感觉诱发电位的中枢传导时间（CCT）的影响进行了研究。这8例患者均表现出严重的血管造影血管痉挛和脑缺血体征。每8小时静脉注射15 - 20微克Lipo-PGE1，持续5至7天。在首次使用Lipo-PGE1治疗后的6小时内，报告了局部脑血流量（rCBF）和CCT测量结果，以记录治疗效果。治疗前右侧大脑前、中、后动脉的rCBF平均值分别为46.6±6.8、56.4±7.3和58.8±8.9 ml/100 g/min，左侧分别为52.1±9.2、49.1±10.8和56.1±9.2 ml/100 g/min。治疗后，右侧血流量分别增加到53.0±6.9、64.3±5.3和63.0±4.6 ml/100 g/min，左侧分别为60.8±9.4、60.6±9.7和60.6±7.2 ml/100 g/min。首次使用PGE1治疗后，CCT也从6.36毫秒改善到6.21毫秒。（摘要截取自250字）
