Li P A, Kristián T, Shamloo M, Siesjö K
Laboratory for Experimental Brain Research, Lund University, Sweden.
Stroke. 1996 Sep;27(9):1592-601; discussion 1601-2. doi: 10.1161/01.str.27.9.1592.
The objective of this study was to explore whether preischemic hyperglycemia, which is known to aggravate brain damage due to transient global or forebrain ischemia of intermediate duration (10 to 20 minutes), increases the density of selective neuronal necrosis, as observed primarily in the CA1 sector of the hippocampus after brief periods of forebrain ischemia in rats (2.5 and 5 minutes).
Anesthetized rats were subjected to two-vessel forebrain ischemia of 2.5- or 5-minute duration. Normoglycemic or hyperglycemic rats were either allowed a recovery period of 7 days for histopathological evaluation of neuronal necrosis in the hippocampus, isocortex, thalamus, and substantia nigra or were used for recording of extracellular concentrations of Ca2+ ([Ca2+]c), K+, or H+, together with the direct current (DC) potential.
Ischemia of 2.5- or 5-minute duration gave rise to similar damage in the CA1 sector of the hippocampus in normoglycemic and hyperglycemic groups (10% to 15% and 20% to 30% of the total population, respectively). However, in hyperglycemic animals subjected to 2.5 minutes of ischemia, CA1 neurons never depolarized and [Ca2+]c did not decrease. In the 5-minute groups, the total period of depolarization was 2 to 3 minutes shorter in hyperglycemic than in normoglycemic groups. This fact and results showing neocortical, thalamic, and substantia nigra damage in hyperglycemic animals after 5 minutes of ischemia demonstrate that although hyperglycemia delays the onset of ischemic depolarization and hastens repolarization and extrusion of Ca2+, it aggravates neuronal damage due to ischemia.
These results reinforce the concept that hyperglycemia exaggerates brain damage due to transient ischemia and prove that this exaggeration is observed at the neuronal level. The results also suggest that the concept of the duration of an ischemic transient should be qualified, particularly if ischemia is brief, ie. < 10 minutes in duration.
本研究的目的是探讨缺血前高血糖是否会增加选择性神经元坏死的密度。已知缺血前高血糖会加重因短暂性全脑或前脑中度缺血(10至20分钟)所致的脑损伤,这种损伤主要表现为大鼠前脑短暂缺血(2.5分钟和5分钟)后海马CA1区的神经元坏死。
对麻醉的大鼠进行持续2.5分钟或5分钟的双侧前脑缺血。正常血糖或高血糖大鼠要么给予7天的恢复期,用于对海马、异皮质、丘脑和黑质中的神经元坏死进行组织病理学评估,要么用于记录细胞外Ca2+([Ca2+]c)、K+或H+的浓度以及直流(DC)电位。
在正常血糖和高血糖组中,持续2.5分钟或5分钟的缺血在海马CA1区造成了相似的损伤(分别占总神经元数量的10%至15%和20%至30%)。然而,在经历2.5分钟缺血的高血糖动物中,CA1神经元从未发生去极化,且[Ca2+]c也未降低。在5分钟组中,高血糖组的去极化总时长比正常血糖组短2至3分钟。这一事实以及显示高血糖动物在缺血5分钟后出现新皮质、丘脑和黑质损伤的结果表明,尽管高血糖延迟了缺血性去极化的发生并加速了复极化以及Ca2+的排出,但它会加重缺血所致的神经元损伤。
这些结果强化了高血糖会加剧短暂性缺血所致脑损伤的概念,并证明这种加剧在神经元水平上是可见的。结果还表明,缺血短暂期时长的概念应加以限定,特别是在缺血短暂(即持续时间<10分钟)的情况下。