Nishiyama Y, Katayama Y
Second Department of Internal Medicine, Nippon Medical School, Tokyo, Japan.
Nihon Ika Daigaku Zasshi. 1998 Dec;65(6):450-8. doi: 10.1272/jnms1923.65.450.
The pathological mechanism responsible for cerebral white matter lesions, frequently observed in elderly individuals, is supposed to be chronic cerebral hypoperfusion Vascular risk factors such as hypertension and carotid artery stenosis are usually involved in these lesions. The objective of this study was to elucidate the role of hypertension in white matter changes using a bilateral carotid artery stenosis model. To induce cerebral hypoperfusion, chronic stenosis was produced by placing a 3 mm long polyethylene cuff around the bilateral carotid arteries of normotensive Wistar rats (Wistar) and spontaneously hypertensive rats (SHR). Two different diameters of tube, PE-50 (inside diameter 0.58 mm) and PE-60 (inside 0.76 mm), were used to induce different degrees of stenosis. The rats were divided into three groups, sham group, PE-50 group, and PE-60 group (each group included 15 Wistar and 15 SHR). At 1,2, and 4 weeks after the operation, pathological changes in which matter were observed in the corpus callosum, and the degree of lesions was assessed using the Vacuole Index. PaO2, PaCO2, pH and mean arterial blood pressure (MABP) were measured prior to and immediately after carotid stenosis. MABP in SHR was significantly higher than in Wistar in all groups (p < 0.05). Other physiological data did not differ significantly between Wistar and SHR. There was no difference in white matter changes between the Wistar sham and SHR sham groups at any time point. There was only a small degree of white matter lesions in the Wistar PE-50 and -60 groups after 4 weeks stenosis, and they did not differ significantly from the sham. In both the SHR PE-50 and -60 groups, however, white matter lesions were slightly apparent at 1 week, and were clearly visible at 4 weeks. The degree of lesions in the SHR PE-50 was significantly higher at 1 week than in the sham (p < 0.01), and both the sham and the Wistar PE-50 at 2 and 4 weeks (p < 0.01), and the SHR PE-60 at 4 weeks (p < 0.01). The SHR PE-60 also had significantly more lesions than the sham at 2 weeks (p < 0.05), and both the sham and the Wistar PE-60 at 4 weeks (p < 0.01). These findings indicate that both hypertension and chronic hypoperfusion play important roles in the development of white matter lesions.
脑白质病变在老年人中经常可见,其病理机制被认为是慢性脑灌注不足。高血压和颈动脉狭窄等血管危险因素通常与这些病变有关。本研究的目的是使用双侧颈动脉狭窄模型阐明高血压在白质变化中的作用。为了诱导脑灌注不足,通过在正常血压的Wistar大鼠(Wistar)和自发性高血压大鼠(SHR)的双侧颈动脉周围放置一个3毫米长的聚乙烯套管来产生慢性狭窄。使用两种不同直径的管子,PE - 50(内径0.58毫米)和PE - 60(内径0.76毫米)来诱导不同程度的狭窄。大鼠被分为三组,假手术组、PE - 50组和PE - 60组(每组包括15只Wistar大鼠和15只SHR大鼠)。在手术后1、2和4周,观察胼胝体中白质的病理变化,并使用空泡指数评估病变程度。在颈动脉狭窄之前和之后立即测量动脉血氧分压(PaO₂)、动脉血二氧化碳分压(PaCO₂)、pH值和平均动脉血压(MABP)。所有组中SHR的MABP均显著高于Wistar大鼠(p < 0.05)。Wistar大鼠和SHR大鼠之间的其他生理数据没有显著差异。在任何时间点,Wistar假手术组和SHR假手术组之间的白质变化没有差异。在狭窄4周后,Wistar大鼠的PE - 50组和PE - 60组只有轻微程度的白质病变,与假手术组没有显著差异。然而,在SHR大鼠的PE - 50组和PE - 60组中,白质病变在1周时略有显现,在4周时清晰可见。SHR大鼠的PE - 50组在1周时的病变程度显著高于假手术组(p < 0.01),在2周和4周时高于假手术组和Wistar大鼠的PE - 50组(p < 0.01),在4周时SHR大鼠的PE - 60组也高于假手术组(p < 0.01)。SHR大鼠的PE - 60组在2周时的病变也显著多于假手术组(p < 0.05),在4周时多于假手术组和Wistar大鼠的PE - 60组(p < 0.01)。这些发现表明高血压和慢性灌注不足在白质病变的发展中都起重要作用。