Kennealy J A, McLennan J E, Fields C, McLaurin R L, Loudon R G, Kammerer C M
Clin Invest Med. 1984;7(2):103-8.
Acetazolamide could theoretically impair oxygen delivery to cerebral tissue by inhibiting local acidification of capillary blood. There is considerable evidence, however, that acetazolamide improves cerebral oxygen tension. This experiment was designed to demonstrate increased deep cerebral oxygen tension after acetazolamide. Three groups of dogs were anesthetized with pentobarbital and ventilated with a respirator. A Teflon-coated stainless steel catheter was placed through a craniotomy into the parietal lobe and advanced into the corona radiata to monitor cerebral pO2 and pCO2 with a mass spectrometer. Group one dogs were normoxic and eucapneic. Group two dogs were hypoxemic, and Group three dogs were hypocapneic. After control cerebral and arterial gas tensions had been recorded, acetazolamide (30 mg kg-1) was injected intravenously. Cerebral gas tensions were monitored continuously and arterial gases were analyzed at 30, 60, 90 and 120 min. Cerebral oxygen tension was not decreased by acetazolamide in any of the dogs. Cerebral carbon dioxide tension was increased by acetazolamide in all dogs. We conclude that acetazolamide does not deplete cerebral oxygen tension even in the face of hypoxemia or acute hypocapnea.
从理论上讲,乙酰唑胺可通过抑制毛细血管血液的局部酸化来损害脑组织的氧输送。然而,有大量证据表明乙酰唑胺可提高脑氧分压。本实验旨在证明使用乙酰唑胺后深部脑氧分压会升高。三组犬用戊巴比妥麻醉并用呼吸机通气。将一根涂有聚四氟乙烯的不锈钢导管通过开颅手术插入顶叶,然后推进到放射冠以用质谱仪监测脑pO2和pCO2。第一组犬为正常氧合和正常碳酸血症。第二组犬为低氧血症,第三组犬为低碳酸血症。在记录对照脑和动脉血气张力后,静脉注射乙酰唑胺(30 mg/kg)。持续监测脑血气张力,并在30、60、90和120分钟时分析动脉血气。在任何一只犬中,乙酰唑胺均未降低脑氧张力。在所有犬中,乙酰唑胺均使脑二氧化碳张力升高。我们得出结论,即使面对低氧血症或急性低碳酸血症,乙酰唑胺也不会降低脑氧张力。