中药川芎嗪对蛛网膜下腔出血后脑血管痉挛的实验研究  

Experimental study on tetramethylpyrazine against cerebral vasospasm following subarachnoid hemorrhage

作　　者：张宏伟[1] 鲍圣德[1] 孙丕通[2] 董浩[3] 于春江[3] 

机构地区：[1]北京大学第一医院神经外科,北京100034 [2]大连大学附属中山医院神经外科,辽宁大连116001 [3]首都医科大学附属复兴医院神经外科,北京100038

出　　处：《中国微侵袭神经外科杂志》2008年第3期124-127,共4页Chinese Journal of Minimally Invasive Neurosurgery

摘　　要：目的观察川芎嗪(TMP)对蛛网膜下腔出血后脑血管痉挛(CVS)的治疗效果。方法制备能够连续造影的兔CVS动物模型,将其随机分为TMP组、尼莫地平组和对照组,每组13只,各组分别注入TMP60mg/kg、尼莫地平0.1mg/kg及等量生理盐水,观察各组动物的神经功能状态变化,并应用脑血管造影、经颅多普勒(TCD)及电镜技术,了解药物对急、慢性CVS的治疗效果。结果CVS急性期静脉注射TMP、尼莫地平30min后,基底动脉口径分别由(57.17±11.40)%、(58.0±10.90)%扩大到(80.16±14.22)%、(90.0±11.38)%(均P<0.01)。在CVS慢性期,动脉口径扩张不明显(P>0.05),但TCD检测基底动脉的平均血流速度则分别由(57.92±10.54)cm/s、(61.61±11.49)cm/s下降到(36.58±10.39)cm/s、(33.67±7.57)cm/s(均P<0.01);形态学研究显示:对照组基底动脉内皮细胞、平滑肌细胞及神经细胞的损害程度明显重于实验组。结论①TMP能够缓解CVS,明显改善CVS后的神经系统功能损害症状。②TMP与尼莫地平对CVS同样具有良好的治疗效果,但TMP60mg/kg对脑组织、血管组织的保护作用优于尼莫地平0.1mg/kg。Objective To observe the effects of tetramethylpyrazine （TMP） on cerebral vasospasm caused by subarachnoid hemorrhage. Methods Model of cerebral vascular spasm （CVS） rabbit was used for the purpose of continuous cerebral angiography.Thirty-nine rabbits with CVS were randomly divided into 3 groups, 13 each： TMP group with TMP injection of 60 mg/kg, nimodipine group with nimodipine injection of 0.1mg/kg and NS group for control. Changes in neural function and effects of medications on acute and chronic CVS were observed by cerebral angiography, transcranial Doppler sonography （TCD） and electron microscopy. Results In acute stage of CVS, at intravenous injection of TMP and nimodipine for 30 minutes later, diameter of the basilar artery enlarged from 57.17±11.40%, 58.0±10.92% to 80.16±14.22% and 90.0±11.38% respectively （P 〈0.01）. In chronic stage of CVS, there was no statistical difference betWeen the two medications in enlargement of basilar artery diameter （P 〉 0.05）. However, the mean blood flow velocity of the basilar artery detected by TCD decreased from 57.92±10.54 cm/s and 61.61±11.49 cm/s to 36.58±10.39 cm/s and 33.67±7.57 cm/s （P 〈0.01） respectively. Lesions of endotheliocyte, smooth muscle cell and neurocyte in the basilar artery of the control group were much more severe than those of the two drug groups. Conclusion Both TMP and Nimodipine can relieve CVS and significantly improve the symptoms of nervous system damage after CVS. In aspect of brain and vascular tissue protection, 60 mg/kg TMP is better than 0.1 mg/kg nimodipine.

关 键 词：川芎嗪 血管痉挛 颅内 蛛网膜下腔出血 超声检查 多普勒 经颅 

分 类 号：R277.7[医药卫生—中医学]