硫酸镁逆转SAH后脑血管痉挛的实验研究  

Experimental study of magnesium sulfate on cerebral vasospasm following subarachnoid hemorrhage

作　　者：李王安[1] 杨应明[1] 蔡楚伟[1] 许燕凯[1] 陈伟强[1] 张琦辉[1] 

机构地区：[1]汕头大学医学院第一附属医院神经外科,515041

出　　处：《实用医学杂志》2005年第14期1497-1499,共3页The Journal of Practical Medicine

摘　　要：目的:探讨硫酸镁对蛛网膜下腔出血(SAH)后脑血管痉挛的防治作用。方法:采用“枕大池一次注血法”复制兔SAH模型,治疗组予硫酸镁静脉输入,单纯注血组则予等量生理盐水。术前和术后全程观察实验动物的饮食及神经功能变化情况,利用HE染色及透射电镜分别观察各组处理后第5天兔基底动脉血管形态学及超微结构改变。结果:(1)单纯注血组兔摄食量逐渐下降、神经功能障碍逐渐加重;治疗组摄食量稍有下降,神经功能障碍较轻,且逐渐好转。(2)单纯注血组兔基底动脉血管管径显著小于正常组(P<0.01),而经硫酸镁处理后,治疗组血管管径明显大于单纯注血组(P<0.05),与正常组差异无显著性(P>0.05),部分管径甚至大于正常组。(3)单纯注血组血管壁增厚、结构紊乱,内皮细胞紧密连接消失,内弹力膜皱折、虫蚀样改变,平滑肌细胞变性、核扭曲等。治疗组上述结构改变较轻。结论:硫酸镁能明显逆转SAH后的脑血管痉挛,且有良好的神经保护作用。Objective To study the therapeutic effect of magnesium sulfate(MgSO4) on cerebral vasospasm following subarachnoid hemorrhage(SAH). Methods After successfully duplicated experimental rabbit SAH model by using simple subrachnoid hemorrhage,we gave the treatment group with MgSO4 and only-SAH group with equal amount of NS. The diet and nervous function of every animal before and after the operation were recorded. The morphological and ultrastructural changes in the artery on the 5th day were observed with HE stain and transmission electron microscope techniques. Results (1)All rabbits in simple-SAH group showed decreasing diet amount and deteriorating nervous function,while in treatment group,the above situations were mild. (2)The basilar artery lumens were significant narrower in simple-SAH group compared with normal group(P< 0.05).With MgSO4 treated,the artery lumens dilated markedly,larger than that of simple-SAH group(P< 0.05),but no significance compared with normal group(P >0.05). (3)In simple-SAH group,the vessel wall was thickened and the structure of the vessel wall was disordered,the internal elastic membrane was folded and vermiformed,endothelial and smooth muscle cells degenerated and nucleus distorted. All above pathological changes were slight in treatment group. Conclusion MgSO4 not only can reverse cerebral vasospasm following SAH but also has neuroprotective effect.

关 键 词：脑血管痉挛 硫酸镁 实验研究 蛛网膜下腔出血(SAH) 逆转 神经功能障碍 超微结构改变 细胞紧密连接 神经保护作用 基底动脉 血管管径 血管形态学 血管壁增厚 治疗组 正常组 防治作用 静脉输入 生理盐水 变化情况 实验动物 

分 类 号：R743.3[医药卫生—神经病学与精神病学]