人组织激肽释放酶对兔脑血管痉挛的影响  

Effects of human tissue kallikrein on cerebral vasospasm： experiment with rabbits

作　　者：王均炉[1] 周乐平[1] 裴圣林[1] 胡章勇[2] 虞慧畅[1] 陈伟健[2] 

机构地区：[1]温州医学院附属第一医院麻醉科,温州325000 [2]温州医学院附属第一医院影像中心,温州325000

出　　处：《中华医学杂志》2008年第29期2069-2072,共4页National Medical Journal of China

基　　金：浙江省科技计划基金资助项目（2008C33037）

摘　　要：目的探讨人组织激肽释放酶（HTK）对兔蛛网膜下腔出血（SAH）后症状性脑血管痉挛（CVS）的影响。方法建立兔CVS模型，将双侧颈总动脉结扎2周后存活的兔子随机分为4组：假手术（Sham）组、蛛网膜下腔出血（SAH）组、HTK组，尼莫地平（ND）组。除Sham组外，其余3组动物行二次枕大池注血。后两组于第1次注血后第1～5天分别经静脉给HTK或ND。所有动物于第6天处死。用三维CT血管造影（3D-CTA）观察各组注血前后基底动脉直径变化，并对比基底动脉病理改变。结果与SAH组相比，HTK组基底动脉痉挛不明显（P〈0．01），光镜见基底动脉病理改变不明显，ND组基底动脉痉挛无明显缓解（P〉0．05）。结论SAH后早期应用人组织激肽释放酶对兔脑血管痉挛具有明显的改善作用。Objective To study the effects of human tissue kallikrein （HTK）on symptomatic cerebral vasospasm （CVS） after subarachnoid hemorrhage （ SAH ）. Methods Forty rabbits underwent occlusion of bilateral carotid. Two weeks later the 28 surviving rabbits were randomly divided into to 4 groups ： shamed-operation group （ n = 8 ） undergoing injection of normal saline into the cisterna magna on day 1 and day 3, SAH group （n = 6 ） undergoing injection of nonheparinized autologous arterial blood into the cisterna magna, HTK therapy group （n = 6） undergoing blood injection into the cisterna magna and then injection of HTK via ear marginal vein daily for 3 days, and nimedipine （ND） therapy group （ n = 6 ） undergoing blood injection into the cisterna magna and then injection of ND via ear marginal vein. 3- dimension -CT angiography （3-D CTA） was used to measure the basilar artery diameter on D0 and D5. On D6 the rabbits were killed with their basilar arteries taken out to undergo light microscopic examination. Results Blood could be seen in the basis cephalic of the 3 groups undergoing blood injection. 3-D CTA showed that arteriospasm was seen in the SAH and ND groups but not in the HTK group. Microscopy showed obvious pathological changes in basilar artery in the SAH and ND groups but not in the HTK group. Conclusion HTK given early after SAH effectively alleviates the symptomatic cerebral vasospasm.

关 键 词：蛛网膜下腔出血 血管痉挛 颅内 组织激肽释放酶 兔 

分 类 号：R686[医药卫生—骨科学]