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全脑缺血期间大鼠脑温的调节未能影响细胞外乳酸水平。

Brain temperature modulations during global ischemia fail to influence extracellular lactate levels in rats.

作者信息

Lin B, Busto R, Globus M Y, Martinez E, Ginsberg M D

机构信息

Department of Neurology, University of Miami School of Medicine, FL 33101, USA.

出版信息

Stroke. 1995 Sep;26(9):1634-8. doi: 10.1161/01.str.26.9.1634.

Abstract

BACKGROUND AND PURPOSE

While brain tissue lactate increases during cerebral ischemia and is known to be important in the pathogenesis of ischemic brain injury, patterns of extracellular lactate accumulation have been less well characterized, and the influence of brain temperature has not been previously investigated. Mild brain temperature modulations are known to affect the outcome of ischemia dramatically. This study examined changes of extracellular lactate during and after global cerebral ischemia, in which intraischemic brain temperature was held at either 30 degrees C, 37 degrees C, or 39 degrees C.

METHODS

Halothane-anesthetized fasted male Wistar rats underwent 20 minutes of global cerebral ischemia produced by bilateral carotid artery occlusions plus systemic hypotension (40 to 50 mm Hg). Rectal temperature was maintained at 37 degrees C throughout, and intraischemic brain temperature was held at either 30 degrees C (n = 6), 37 degrees C (n = 5), or 39 degrees C (n = 5). Before and after the ischemic insult, brain temperature was maintained at 37 degrees C in all groups. A microdialysis cannula was implanted in the right dorsolateral striatum and perfused with Ringer's solution. Dialysate samples were collected at 10-minute intervals before, during, and after ischemia and were analyzed for lactate by enzymatic-fluorometric techniques.

RESULTS

In all groups, extracellular lactate rose during ischemia and peaked at 10 to 30 minutes of recirculation. Maximal extracellular lactate elevations were sevenfold, eightfold, and eightfold above control in the 30 degrees C, 37 degrees C, 39 degrees C groups, respectively. Significant elevations with respect to control were observed in all groups at 10 to 30 minutes of recirculation. In the 30 degrees C group, these elevations above control were also significant at the 10- and 20-minute ischemic time points (P = .001). At 30 minutes of recirculation, however, lactate levels were lower in the 30 degrees C rats than in the other groups.

CONCLUSIONS

These data provide evidence that extracellular lactate accumulation is not a crucial determinant of ischemic brain injury. Our results suggest that the increased lactate release during ischemia and the accelerated clearance of lactate during recirculation might contribute in part to the neuroprotection of intraischemic hypothermia.

摘要

背景与目的

虽然脑组织乳酸在脑缺血期间会增加,且已知其在缺血性脑损伤的发病机制中起重要作用,但细胞外乳酸积累的模式尚未得到充分描述,且脑温的影响此前尚未被研究。已知轻度脑温调节会显著影响缺血的结局。本研究检测了全脑缺血期间及之后细胞外乳酸的变化,其中缺血期间脑温维持在30℃、37℃或39℃。

方法

用氟烷麻醉禁食的雄性Wistar大鼠,通过双侧颈动脉闭塞加全身低血压(40至50mmHg)造成20分钟的全脑缺血。整个过程中直肠温度维持在37℃,缺血期间脑温维持在30℃(n = 6)、37℃(n = 5)或39℃(n = 5)。在缺血损伤前后,所有组的脑温均维持在37℃。将微透析套管植入右侧背外侧纹状体,并用林格氏液灌注。在缺血前、缺血期间和缺血后,每隔10分钟收集透析液样本,并采用酶荧光法分析乳酸含量。

结果

在所有组中,细胞外乳酸在缺血期间升高,并在再灌注10至30分钟时达到峰值。在30℃、37℃、39℃组中,细胞外乳酸的最大升高幅度分别比对照组高7倍、8倍和8倍。在再灌注10至30分钟时,所有组相对于对照组均有显著升高。在30℃组中,在缺血10分钟和20分钟时,这些高于对照组的升高也具有显著性(P = .001)。然而,在再灌注30分钟时,30℃大鼠的乳酸水平低于其他组。

结论

这些数据表明,细胞外乳酸积累并非缺血性脑损伤的关键决定因素。我们的结果表明,缺血期间乳酸释放增加以及再灌注期间乳酸清除加速可能部分有助于缺血性低温的神经保护作用。

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