摘要
目的:观察腰大池持续引流的不同时期,犬症状性蛛网膜下腔出血后脑脊液中内皮细胞衍生性血管收缩因子内皮素和内皮细胞衍生性血管舒张因子一氧化氮的变化与脑血管痉挛的关系。方法:实验于2004-05/2004-10在武汉总医院实验中心完成,取普通级成年健康家犬20只,雌雄不拘,体质量12～22kg,平均15kg。采用二次注血法建立犬症状性蛛网膜下腔出血模型,完全随机分组,引流组10只,蛛网膜下腔出血模型行腰大池持续引流脑脊液14d,每日引流100mL左右;腰穿组10只,即对照组,1次/d腰穿,抽取脑脊液8～10mL。测定蛛网膜下腔出血后腰大池持续引流前后不同时期,脑脊液中内皮素和一氧化氮浓度,观察内皮素和一氧化氮浓度动态变化,同时应用经颅彩色多普勒超声观察犬症状性蛛网膜下腔出血模型不同时期脑动脉血液流速,根据基底动脉平均流速判断和评价脑血管痉挛程度。结果:①脑脊液中血管收缩因子内皮素的变化:犬蛛网膜下腔出血后,脑脊液中内皮素浓度均有明显增高,第7天达到高峰,且腰穿组较引流组升高明显[(57.95±17.95),(34.15±7.19)ng/L,t=6.108,P<0.01];②脑脊液中血管舒张因子一氧化氮浓度的变化:出血后第3,7,10天两组脑脊液中一氧化氮浓度均下降,腰穿组较引流组下降明显[(1.20±0.25,1.20±0.25);(2.29±1.43,1.02±0.29);(3.26±1.43,0.88±0.28)μmol/L;t=15.624,P<0.01]。③两组基底动脉平均血流速度的变化:腰穿组蛛网膜下腔出血后第7,10天基底动脉平均流速比出血前和出血后3d明显增高[(39.67±14.76),(38.97±9.76),(10.97±4.85),(18.68±13.55)cm/s,t=8.231,P<0.01],引流组蛛网膜下腔出血后第7天基底动脉平均流速与出血前和出血后第3天比较无明显增高[(15.15±4.83),(13.59±4.64),(10.89±3.67)cm/s,t=1.879,P>0.05];基底动脉出现平均流速>40cm/s的重度脑血管痉挛时,脑血流出现涡流或湍流。④相关因素分析结果:脑脊液中内皮
AIM：To investigate the relationship of endothelin（ET） and nitric oxide（NO） in cerebrospinal fluid （CSF） with cerebral vasospasm（CVS） in canines with symptomatic subarachnoid hemorrhage（SAH） during different period of continuous lumbar drainage. METHODS：The experiment was conducted in the Central Laboratory of Wuhan General Hospital from May to October 2004. Twenty healthy adult canines of either sex,weighing 12-22 kg,were selected. After symptomatic SAH models were established, all the canines were randomized into a drainage group （n=10） to receive continuous lumbar drainage for 14 days （100 mL daily）, and a lumbar puncture group （n=10） to received lumbar puncture once a day. 8-10 mL of CSF was extracted to determine the levels of ET and NO at different period of continuous lumbar drainage following SAH, and transcranial color Dopplor was applied to evaluate CVS by the mean velocity of basal artery blood flow . RESULTS：①ET changes： After SAH, the concentration of ET in CSF increased significantly in the drainage group and lumbar puncture group, and reached the peak at the 7^th day, especially that in the lumbar puncture group [（57.95±17.95）, （34.15±7.19） ng/L,t=6.108,P 〈 0.01]. ② NO changes： The concentration of NO in CSF decreased in the two groups at days 3, 7, and 10 following SAH, especially that in the lumbar puncture group [（1.20 ±0.25,1.20 ±0.25） ; （2.29 ±1.43,1.02 ±0.29） ; （3.26 ±1.43, 0.88±0.28）μmol/L;t=15.624,P 〈 0.01]. ③ Mean velocity of basal artery blood flow： In the lumbar puncture group, the mean velocity of basal artery blood flow at days 7 and 10 after SAH was dramatically higher than that before SAH and at day 3 after SAH [（39.67±14.76）, （38.97±9.76）, （10.97 ±4.85）, （18,68±13.55） cm/s,t=8.231 ,P 〈 0.01]. In the lumbar drainage group, the mean velocity of basal artery blood flow at day 7 after SAH had no changes as compared with that before SAH and at day 3 after SAH [（15,15±4,83）. （ 13
出处
《中国临床康复》
CSCD
北大核心
2005年第29期90-91,共2页
Chinese Journal of Clinical Rehabilitation
