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[高碳酸血症通气引起的脑细胞外pH值、脑血流量和颅内压变化——作为脑酸中毒潜在体内模型的评估]

[Changes in cerebral extracellular pH, cerebral blood flow and intracranial pressure induced by hypercarbic ventilation--assessment as a potential in vivo model of cerebral acidosis].

作者信息

Niiro M, Kadota K, Asakura T, Simon R P

机构信息

Department of Neurosurgery, University of Kagoshima, Japan.

出版信息

No To Shinkei. 1994 Jul;46(7):639-45.

PMID:7946619
Abstract

The effects of acidosis on ischemic brain damage are unclear and probably diverse. To establish an in vivo model of acidosis, the authors assess changes in extracellular brain pH (pHe), CBF and ICP induced by hypercarbic ventilation, and discuss the reliability and short comings of this experimental model. Acidosis was induced by increasing the inspired CO2 concentration in mechanically ventilated rats. pHe was measured with a pH-sensitive electrode implanted into the cortical mantle. The rats were divided into five groups according to the CO2 concentrations inspired: G-1, 0% control; G-2, -5-% CO2; G-3, -10-% CO2; G-4, -20-% CO2; G-5, -25-% CO2. Cortical blood flow was measured using a laser Doppler flowmeter, and ICP was also determined in each of the experimental groups. pHe decreased rapidly after the CO2 supply was turned on and remained almost constant at fixed concentrations of inspired CO2. pHe values diminished as the concentration of inspired CO2 decreased, as follows: G-2, -0.10 +/- 0.03; G-3, -0.31 +/- 0.08; G-4, -0.49 +/- 0.09; G-5, -0.64 +/- 0.10. The changes in pHe almost perfectly paralleled the changes in blood pH. The percentage increase in CBF was more than 200% in the G-2 groups and minimal increases in CBF, probably due to changes in blood pressure, were observed in from G-2 to G-5. Changes in CBF paralleled changes in systemic blood pressure, especially after the CO2 supply was turned off. ICP also rose after increasing the CO2 supply, and the pattern of changes was similar to that of CBF.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

酸中毒对缺血性脑损伤的影响尚不清楚,可能是多方面的。为建立酸中毒的体内模型,作者评估了高碳酸血症通气引起的细胞外脑pH值(pHe)、脑血流量(CBF)和颅内压(ICP)的变化,并讨论了该实验模型的可靠性和不足之处。通过增加机械通气大鼠吸入的二氧化碳浓度来诱导酸中毒。用植入皮质的pH敏感电极测量pHe。根据吸入的二氧化碳浓度将大鼠分为五组:G-1,0%为对照组;G-2,5%二氧化碳;G-3,10%二氧化碳;G-4,20%二氧化碳;G-5,25%二氧化碳。使用激光多普勒流量计测量皮质血流量,并且在每个实验组中也测定了ICP。开启二氧化碳供应后,pHe迅速下降,并在固定的吸入二氧化碳浓度下几乎保持恒定。随着吸入二氧化碳浓度的降低,pHe值减小,如下:G-2,-0.10±0.03;G-3,-0.31±0.08;G-4,-0.49±0.09;G-5,-0.64±0.10。pHe的变化几乎与血液pH值的变化完全平行。G-2组中CBF的增加百分比超过200%,并且从G-2到G-5观察到CBF的增加最小,这可能是由于血压变化所致。CBF的变化与全身血压的变化平行,特别是在关闭二氧化碳供应后。增加二氧化碳供应后ICP也升高,并且变化模式与CBF相似。(摘要截短于250字)

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