Hirata H, Asanuma M, Tanaka K, Kondo Y, Ogawa N
Department of Neuroscience, Okayama University Medical School, Japan.
Stroke. 1995 Jul;26(7):1268-72. doi: 10.1161/01.str.26.7.1268.
Hypertension is a primary aggravating factor in cerebral infarction. An acute rise in blood pressure (BP) at the time of a stroke may be harmful to the brain in a hypertensive subject because both cerebral vascular structure and function are altered by hypertension. Muscarinic M1 receptors are concerned with memory and learning. We aimed to evaluate the effect of controlling BP in hypertensive subjects at the time of stroke with a biochemical index of brain damage.
We gave a single dose of either the antihypertensive alpha-blocker phentolamine (2 mg/kg IP) or the calcium antagonist nicardipine (2 mg/kg IP) at the start of bilateral carotid artery occlusion to spontaneously hypertensive rats undergoing 3 hours of transient ischemia; we measured the time course of mean BP (MBP) and changes in the M1 receptor and its mRNA in three brain regions 2 weeks after the transient ischemia.
Administration of phentolamine or nicardipine not only significantly suppressed the ischemia-induced rise of MBP, it actually decreased MBP during ischemia. In an ischemic control group, M1 receptor binding decreased in the frontal cortex and M1 receptor mRNA increased in the hippocampus 2 weeks after the ischemia. In contrast, both phentolamine- and nicardipine-treated ischemic rats showed no changes in either index compared with sham-operated controls.
Controlling BP during an ischemic insult attenuates ischemia-induced damage of M1 receptors in the brain of spontaneously hypertensive rats. These results suggest that a rapid intensive increase of BP at the time of a stroke may exacerbate brain damage in hypertensive individuals.
高血压是脑梗死的主要加重因素。中风时血压急性升高对高血压患者的大脑可能有害,因为高血压会改变脑血管的结构和功能。毒蕈碱M1受体与记忆和学习有关。我们旨在通过脑损伤的生化指标评估中风时控制高血压患者血压的效果。
在双侧颈动脉闭塞开始时,给经历3小时短暂缺血的自发性高血压大鼠单次注射抗高血压α受体阻滞剂酚妥拉明(2mg/kg腹腔注射)或钙拮抗剂尼卡地平(2mg/kg腹腔注射);我们在短暂缺血2周后测量三个脑区平均血压(MBP)的时间进程以及M1受体及其mRNA的变化。
注射酚妥拉明或尼卡地平不仅显著抑制了缺血诱导的MBP升高,实际上还在缺血期间降低了MBP。在缺血对照组中,缺血2周后额叶皮质的M1受体结合减少,海马体中的M1受体mRNA增加。相比之下,与假手术对照组相比,酚妥拉明和尼卡地平治疗的缺血大鼠在这两个指标上均无变化。
在缺血性损伤期间控制血压可减轻自发性高血压大鼠大脑中缺血诱导的M1受体损伤。这些结果表明,中风时血压快速剧烈升高可能会加重高血压个体的脑损伤。