Kajita Y, Takayasu M, Dietrich H H, Dacey R G
Department of Neurosurgery, Washington University School of Medicine, St. Louis, Missouri 63110, USA.
Neurosurgery. 1998 Apr;42(4):834-41; discussion 841-2. doi: 10.1097/00006123-199804000-00087.
Cerebral autoregulation is an important regulatory mechanism that maintains a constant cerebral blood flow over a wide range of perfusion pressures. The goal of this study was to determine whether nitric oxide contributes to the autoregulatory response of cerebral arterioles to altered transmural pressure (TMP).
Seventy-nine intraparenchymal arterioles (53.6 +/- 3.5 microm mean diameter) isolated from rats were cannulated with micropipettes and pressurized at a TMP of 60 mm Hg (control pressure). Vessel diameters were monitored continuously using a video dimensional analyzer. The autoregulatory diameter responses to varying intraluminal pressures were observed in the presence and absence of a nitric oxide synthase inhibitor, NG-monomethyl-L-arginine (L-NMMA). The effect of L-NMMA-induced constriction on autoregulatory response also was compared with responses after prostaglandin F2alpha and alkalosis-induced constrictions.
Autoregulatory responses were observed over a range from 10 to 90 mm Hg of TMP. Treatment with 10(-4) mol/L L-NMMA constricted arterioles and inhibited the autoregulatory vasodilation to TMP reductions from 60 mm Hg to 10 or 30 mm Hg. In L-NMMA-treated arterioles, elevation in TMP from 60 to 90 mm Hg caused an autoregulatory vasoconstriction. Treatment with alkaline pH 7.65 constricted arterioles to a similar degree as that induced by L-NMMA at 60 mm Hg, and under these conditions, the autoregulatory response remained intact. Arterioles severely constricted with prostaglandin F2alpha showed no significant autoregulatory response.
These results suggest that 1) vascular nitric oxide release increases in response to a decrease in TMP from 60 mm Hg, thereby contributing to the autoregulatory vasodilation intrinsic to the vessel during hypotension, 2) arteriolar nitric oxide appears not to be involved in the autoregulatory vasoconstriction induced by elevating TMP from 60 to 90 mm Hg, and 3) a marked increase in vascular tone may affect autoregulatory response.
脑自动调节是一种重要的调节机制,可在广泛的灌注压范围内维持恒定的脑血流量。本研究的目的是确定一氧化氮是否有助于脑小动脉对跨壁压(TMP)改变的自动调节反应。
从大鼠分离出79根脑实质内小动脉(平均直径53.6±3.5微米),用微量移液器插管,并在60毫米汞柱的TMP(对照压力)下加压。使用视频尺寸分析仪连续监测血管直径。在存在和不存在一氧化氮合酶抑制剂NG-单甲基-L-精氨酸(L-NMMA)的情况下,观察对不同管腔内压力的自动调节直径反应。还将L-NMMA诱导的收缩对自动调节反应的影响与前列腺素F2α和碱中毒诱导的收缩后的反应进行了比较。
在10至90毫米汞柱的TMP范围内观察到自动调节反应。用10⁻⁴摩尔/升L-NMMA处理使小动脉收缩,并抑制了从60毫米汞柱降至10或30毫米汞柱时TMP降低引起的自动调节血管舒张。在L-NMMA处理的小动脉中,TMP从60毫米汞柱升高到90毫米汞柱会引起自动调节血管收缩。用pH 7.65的碱性溶液处理使小动脉收缩的程度与60毫米汞柱时L-NMMA诱导的程度相似,在这些条件下,自动调节反应保持完整。用前列腺素F2α严重收缩的小动脉未显示出明显的自动调节反应。
这些结果表明,1)血管一氧化氮释放随着TMP从60毫米汞柱降低而增加,从而有助于低血压期间血管固有的自动调节血管舒张;2)小动脉一氧化氮似乎不参与TMP从60毫米汞柱升高到90毫米汞柱诱导的自动调节血管收缩;3)血管张力的显著增加可能影响自动调节反应。