不同剂量人组织激肽释放酶对兔症状性脑血管痉挛的影响  

Effects of different doses of human tissue kailikrein on symptomatic cerebral vasospasm in rabbits

作　　者：莫云长[1] 王一川[1] 董冬梅[1] 王均炉[1] 晁娟[1] 刘珺[1] 陈伟建[2] 

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

出　　处：《中华麻醉学杂志》2010年第2期216-219,共4页Chinese Journal of Anesthesiology

基　　金：浙江省科技计划项目（2008H3037）

摘　　要：目的探讨不同剂量人组织激肽释放酶（HTK）对兔症状性脑血管痉挛的影响。方法双侧颈总动脉结扎后2周无神经功能障碍的日本大耳白兔40只，体重2．0—2．5kg，随机分为5组（n=8）：对照组（C组）、症状性脑血管痉挛组（V组）和低、中、高剂量HTK组（L组、M组和H组）。采用枕大池二次注血法建立兔症状性脑血管痉挛模型，V组于第1次枕大池注血后耳缘静脉注射生理盐水5ml／d，L组、M组和H组每天分别耳缘静脉注射HTK 0．0025、0．0050、0．0100PNAU／kg，连续14d。于枕大池注血前1d（T1）及注血后每天评价神经功能并记录进食量，于T1及枕大池第1次注血后5、7、14d（T2-4）时采用三维CT血管造影测定基底动脉直径，第15天时取基底动脉观察病理学结果。结果与C组比较，V组低进食量和神经功能障碍发生率升高（P〈0．05）；与V组比较，L组、M组和H组低进食量与神经功能障碍发生率降低，B时基底动脉直径增加，H组T4时基底动脉直径增加（P〈0．05）；与T1时比较，V组T2,3时基底动脉直径缩短（P〈0．05），L组、M组和H组T2，3时基底动脉直径差异无统计学意义（P〉0．05），T4时基底动脉直径增加（P〈0．05）；与L组和M组比较，H组L时基底动脉直径增加（P〈0．05）。结论耳缘静脉注射HTK（0．0025～0．0100PNAU／kg，连续14d）可改善兔症状性脑血管痉挛，其效应呈剂量依赖性。Objective To investigate the effects of different doses of human tissue kallikrein （HTK） on symptomatic cerebral vasospasm in rabbits. Methods Forty Japanese white rabbits in which bilateral common carotid arteries were ligated without neurological deficits were randomly divided into 5 groups （ n = 8 each） ： group A control; group B subarachnoid hemorrhage （SAH） and group C, D, E SAH ＋ low, medium and high doses of HTK. Cerebral vasospasm （CVS） was induced by injecting non-anticoagulated autologous arterial blood 1 ml into cisterna magna twice at 48 h interval in group B, C, D, E. In group C, D, E HTK 0.002 5, 0.005 0, and 0.010 0 PNAU/kg in 5 ml normal saline were injected iv once a day for 14 consecutive days respectively starting after the first cisterna magna blood injection. In group A and B normal saline was injected instead of HTK. The food intake and neurological deficits were evaluated everyday. The diameter of basilar artery was detected by 3D-CTA at 1 day before （T1 , baseline） and 5, 7, 14 d after cisterna magna blood injection （T2-4） . The basilar artery was removed for pathological examination at 15 day after cisterna injection （T5）. Results The food intake was significantly decreased and the incidence of neurological deficits was increased in group B as compared with group A. IV HTK injection significantly attenuated the decrease in food intake and increase in neurological deficit incidence induced by SAH in group C, D, E as compared with group B. Vasospasm of basilar artery was observed at T2 and T3 in group B but not in other 4 groups. Conclusion IV HTK （0.002 5-0,010 0 PNAU/kg once a day for 14 consecutive days） can ameliorate symptomatic cerebral vasospasm in rabbits induced by SAH in a dose- dependent manner.

关 键 词：组织激肽释放酶类 血管痉挛 颅内 蛛网膜下腔出血 

分 类 号：R743.35[医药卫生—神经病学与精神病学]