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癫痫发作期间及癫痫活动停止后的恢复期大脑内的细胞外和细胞内pH值。

Extra- and intracellular pH in the brain during seizures and in the recovery period following the arrest of seizure activity.

作者信息

Siesjö B K, von Hanwehr R, Nergelius G, Nevander G, Ingvar M

出版信息

J Cereb Blood Flow Metab. 1985 Mar;5(1):47-57. doi: 10.1038/jcbfm.1985.7.

Abstract

The objective of the study was to estimate changes in extracellular pH (pHe) and intracellular pH (pHi) during seizures and in the recovery period following the arrest of seizure activity. Seizures of 5- and 20-min duration were induced in rats by fluorothyl added to the insufflated gas mixture, and recovery for 5, 15, and 45 min was instituted by withdrawal of the fluorothyl supply following 20 min of continuous seizures. Changes in pHe were measured by double-barreled, liquid ion-exchange pH microelectrodes, and in pHi by the CO2 method, following estimation of tissue PCO2 and extracellular fluid (ECF) volume. The animals were either normoxic or rendered moderately hypoxic (arterial PO2 40-50 mm Hg). Upon induction of seizures in normoxic animals, pHe decreased by a mean of 0.36 unit, the values being identical at 5 and 20 min. In moderate hypoxia, seizures sustained for 20 min were accompanied by a further fall in pHe (mean decrease 0.51 unit). The changes in pHe seemed mainly to reflect the nonionic diffusion of lactic acid from cells to the ECF (tissue lactate levels approximately 10 and 15 mumol g-1 during seizures in normoxic and hypoxic animals, respectively). However, the gradual fall in pHe attributable able to lactic acid production was preceded by rapid acidification, sometimes exceeding the steady-state values subsequently attained. This acidification was interpreted to reflect spreading depression and fast transcellular Na+/H+ exchange. Following cessation of seizure discharge, pHe normalized at a surprisingly slow rate, with some acidosis persisting even after 45 min. The difference between cerebrovenous and arterial PCO2 was reduced during seizures and increased in the recovery period, probably reflecting alterations in the blood flow/metabolic rate coupling. Impedance changes were slight, indicating only minor changes in ECF volume. Changes in pHi after 5 min of seizures ranged from 0.20 (normoxic animals) to 0.32 (hypoxic animals) unit, the pHi values after 20 min being 0.07-0.08 unit higher. The results suggest the regulation of pHi during ongoing seizures. Upon arrest of seizure activity, pHi rapidly increased to normal and subsequently to supranormal values. Postepileptic intracellular alkalosis occurred at a time when pHe was still reduced and in spite of the fact that tissue lactate values had not normalized. It is concluded that the rapid normalization of pHi and overt alkalosis were caused by the simultaneously occurring oxidation of lactate, with the removal of a stoichiometrical amount of H+, and the extrusion of H+ from cells, possibly via a Na+/H+ exchanger, the latter probably delaying normalization of pHe.

摘要

本研究的目的是评估癫痫发作期间及癫痫活动停止后的恢复期细胞外pH(pHe)和细胞内pH(pHi)的变化。通过向吹入的气体混合物中添加氟代乙烷在大鼠中诱导持续5分钟和20分钟的癫痫发作,并在持续癫痫发作20分钟后停止供应氟代乙烷,使其恢复5分钟、15分钟和45分钟。通过双管液体离子交换pH微电极测量pHe的变化,通过二氧化碳法测量pHi的变化,此前需先估计组织PCO2和细胞外液(ECF)体积。动物分为常氧组或中度低氧组(动脉血氧分压40 - 50 mmHg)。在常氧动物中诱导癫痫发作时,pHe平均下降0.36个单位,5分钟和20分钟时的值相同。在中度低氧情况下,持续20分钟的癫痫发作伴随着pHe的进一步下降(平均下降0.51个单位)。pHe的变化似乎主要反映了乳酸从细胞向ECF的非离子扩散(常氧和低氧动物癫痫发作期间组织乳酸水平分别约为10和15 μmol g-1)。然而,在由于乳酸生成导致的pHe逐渐下降之前,先出现了快速酸化,有时超过随后达到的稳态值。这种酸化被解释为反映了扩散性抑制和快速的跨细胞Na+/H+交换。癫痫放电停止后,pHe以惊人的缓慢速度恢复正常,甚至在45分钟后仍存在一些酸中毒。癫痫发作期间脑静脉和动脉PCO2之间的差异减小,恢复期增加,这可能反映了血流/代谢率耦合的改变。阻抗变化轻微,表明ECF体积仅有微小变化。癫痫发作5分钟后pHi的变化范围为0.20(常氧动物)至0.32(低氧动物)个单位,20分钟后的pHi值高0.07 - 0.08个单位。结果提示在持续癫痫发作期间pHi受到调节。癫痫活动停止后,pHi迅速升至正常,随后升至超正常水平。癫痫后细胞内碱中毒发生在pHe仍降低时,尽管组织乳酸值尚未恢复正常。结论是,pHi的快速恢复正常和明显的碱中毒是由同时发生的乳酸氧化(去除化学计量的H+)以及H+从细胞中排出(可能通过Na+/H+交换器)引起的,后者可能延迟了pHe的恢复正常。

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