Little J R, Slugg R M, Latchaw J P, Lesser R P
Neurosurgery. 1981 Nov;9(5):552-8. doi: 10.1227/00006123-198111000-00011.
The object of the investigation was to study the effects of concentrated albumin upon the evolution of cerebral infarction. Twenty adult cats lightly anesthetized with ketamine hydrochloride underwent right middle cerebral artery (MCA) occlusion for 6 hours. Ten cats were not treated and 10 cats received concentrated (i.e., 25 g/100 ml) human serum albumin (5 ml/kg i.v.) at the time of MCA occlusion. The blood volume increased 30 to 40% in the cats receiving concentrated albumin. The hematocrit fell for 32 +/- 5% (SD) before occlusion to 23 +/- 6% at 2.5 hours after occlusion in treated cats, whereas the hematocrit in untreated cats remained stable at 35 +/- 5. Regional cerebral blood flow (rCBF) changes in the right sylvian region were similar in the untreated and treated groups. The mean rCBF before occlusion was 42 +/- 11 ml/100 g/minute in the untreated cats and 44 +/- 8 ml/100 g/minute in the treated cats. Untreated and treated cats had similar reductions of rCBF in the right sylvian region to less than or equal to 18 ml/100 g/minute at some point after occlusion. An index of erythrocyte flow and microcirculatory resistance was determined by measuring the transit of 99Tc-labeled erythrocytes in the right sylvian region. The erythrocyte transit time before occlusion was 10 +/- 2 seconds in the untreated group and 9 +/- 1 seconds in the treated group. After 6 hours, the erythrocyte transit was 19 +/- 3 seconds in the untreated group and 15 +/- 3 seconds in the treated group (p less than or equal to 0.1), suggesting that less microcirculatory impairment occurred in some treated cats. Electroencephalographic changes during the initial 3 hours of occlusion were less severe in the treated cats than in the untreated cats, suggesting that the collateral flow in the border zone of the MCA territory initially may have been improved by treatment. Impairment of carbon perfusion, ischemic edema, and neuronal alterations after 6 hours of occlusion were the same in both groups. Increased permeability of the blood-brain barrier to Evans blue dye, however, was more marked in the treated group. The findings of the study indicate that concentrated albumin does not substantially modify the evolution of cerebral infarction.
本研究的目的是探讨浓缩白蛋白对脑梗死演变过程的影响。20只成年猫用盐酸氯胺酮轻度麻醉后，进行右侧大脑中动脉（MCA）闭塞6小时。10只猫未接受治疗，10只猫在MCA闭塞时接受了浓缩（即25g/100ml）人血清白蛋白（5ml/kg静脉注射）。接受浓缩白蛋白的猫的血容量增加了30%至40%。治疗组猫的血细胞比容在闭塞前从32±5%（标准差）降至闭塞后2.5小时的23±6%，而未治疗组猫的血细胞比容保持在35±5%稳定。未治疗组和治疗组右侧颞叶区域的局部脑血流量（rCBF）变化相似。未治疗组猫闭塞前的平均rCBF为42±11ml/100g/分钟，治疗组为44±8ml/单位100g/分钟。未治疗组和治疗组猫在闭塞后的某个时间点，右侧颞叶区域的rCBF均有相似程度的降低，降至小于或等于18ml/100g/分钟。通过测量99Tc标记红细胞在右侧颞叶区域的通过时间来确定红细胞流动和微循环阻力指数。未治疗组闭塞前红细胞通过时间为10±2秒，治疗组为9±1秒。6小时后，未治疗组红细胞通过时间为19±3秒，治疗组为15±3秒（p≤0.1），这表明一些接受治疗的猫的微循环损伤较轻。在闭塞最初3小时内，治疗组猫的脑电图变化比未治疗组猫的轻，这表明治疗可能最初改善了MCA区域边缘带的侧支血流。闭塞6小时后，两组的碳灌注损伤、缺血性水肿和神经元改变相同。然而，血脑屏障对伊文思蓝染料的通透性增加在治疗组更为明显。该研究结果表明，浓缩白蛋白并不能实质性地改变脑梗死的演变过程。
