Hitchon P W, Mouw L J, Rogge T N, Torner J C, Miller A K
Department of Surgery, College of Medicine, University of Iowa, Iowa City, USA.
Neurosurgery. 1996 Oct;39(4):795-803. doi: 10.1097/00006123-199610000-00030.
The extent to which nitric oxide (NO) is involved in the modulation of spinal cord blood flow (SCBF) in the uninjured and injured cord is unknown. To elucidate these questions, the following experiments in anesthetized rats were conducted.
Because NO is an unstable free radical with a half-life of seconds, its role can be understood through the study of the NO synthase inhibitor L-NG-nitroarginine (L-NOARG). L-NOARG was administered intravenously for 30 minutes at a dose of 100 or 500 micrograms/kg/min in 12 and 10 uninjured animals, respectively. SCBF fluctuations at C7-T1 were measured using laser doppler flowmetry. In a second set of 12 rats, L-NOARG (500 micrograms/kg/min) was administered 10 minutes before spinal cord injury using a modified aneurysm clip at C7-T1 and continued for 30 minutes thereafter.
In the uninjured animals, L-NOARG was associated with a dose-dependent increase in mean arterial pressure of 20 to 80% above baseline (P = 0.0001), together with a dose-related decrease in SCBF (P = 0.0373). In the injured animals, L-NOARG was associated with a 48% increase in mean arterial pressure. With L-NOARG, the changes in SCBF from baseline after injury were similar to those of noninjured controls (n = 25) and significantly less than injury controls (n = 18) or those receiving phenylephrine (n = 8).
NO synthase inhibitors, by reducing available NO, cause systemic vasoconstriction and a decrease in SCBF in the uninjured spinal cord. In the injured spinal cord, the administration of L-NOARG results in a redistribution of blood flow with an augmentation in posttraumatic SCBF at the injury site.
一氧化氮(NO)在未损伤和损伤脊髓中对脊髓血流(SCBF)调节作用的程度尚不清楚。为阐明这些问题,对麻醉大鼠进行了以下实验。
由于NO是一种半衰期为几秒的不稳定自由基,可通过研究NO合酶抑制剂L-NG-硝基精氨酸(L-NOARG)来了解其作用。分别对12只和10只未损伤动物静脉注射L-NOARG,剂量为100或500微克/千克/分钟,持续30分钟。使用激光多普勒血流仪测量C7-T1节段的SCBF波动。在另一组12只大鼠中,在使用改良动脉瘤夹于C7-T1节段造成脊髓损伤前10分钟静脉注射L-NOARG(500微克/千克/分钟),并在损伤后持续30分钟。
在未损伤动物中,L-NOARG使平均动脉压较基线升高20%至80%,呈剂量依赖性(P = 0.0001),同时SCBF呈剂量相关性降低(P = 0.0373)。在损伤动物中,L-NOARG使平均动脉压升高48%。使用L-NOARG时,损伤后SCBF相对于基线的变化与未损伤对照组(n = 25)相似,且显著小于损伤对照组(n = 18)或接受去氧肾上腺素的组(n = 8)。
NO合酶抑制剂通过减少可利用的NO,导致全身血管收缩和未损伤脊髓的SCBF降低。在损伤脊髓中,给予L-NOARG导致血流重新分布,损伤部位创伤后SCBF增加。