经椎动脉内持续注射盐酸法舒地尔治疗脑血管痉挛  

Continuous intravertebral artery injection of fasudil hydrochloride in the treatment of cerebral vas- aspasm

作　　者：刘鹏[1] 向健威[1] 潘力[1] 马廉亭[1] 

机构地区：[1]广州军区武汉总医院神经外科,武汉430070

出　　处：《中华实验外科杂志》2011年第4期582-585,共4页Chinese Journal of Experimental Surgery

摘　　要：目的在活体动物模型中持续椎动脉内注射盐酸法舒地尔，观察其在不同时间点对蛛网膜下腔出血（SAH）引起的迟发性脑血管痉挛（CVS）的防治作用，并和静脉内给药对比。方法将日本大耳白兔随机分为椎动脉7d给药组、椎动脉5d给药组、静脉给药组及对照组。枕大池2次注血法建立蛛网膜下腔出血模型，椎动脉给药组经微量注射泵分别于不同时间点开始给予盐酸法舒地尔或5％葡萄糖溶液，静脉给药组经耳缘静脉滴注盐酸法舒地尔，注血前及第5、7天各组均行脑血管造影及血管彩色超声检查，测算基底动脉内径变化的比例和血流峰值速度的变化。7d时处死兔取基底动脉，行光镜、电镜检查，观察其病理改变。结果动、静脉给药各组均对蛛网膜下腔出血引起的基底动脉痉挛有显著保护作用。在第5天，静脉给药组与椎动脉5d给药组的保护作用差异无统计学意义（15．43±4．82）％比（10．37±6．92）％，但与椎动脉7d给药组差异有统计学意义（2．02±6．21）％；在第7天，椎动脉5d组与7d组的保护作用差异无统计学意义（2．60±6．42）％比（0．44±5．12）％，但与静脉给药组差异有统计学意义（8．40±4．28）％。同时用血管彩色超声对各组基底动脉峰值流速进行监测，并行光镜、电镜等病理检查，也支持上述结果。结论脑血管痉挛动物模型中椎动脉内持续注射盐酸法舒地尔对蛛网膜下腔出血引起的脑血管痉挛的保护作用优于静脉内给药。Objective To investigate and compare the effects of continuous intravertebral artery （CIV） injection of fasudil hydrochloride with intravenous injection of fasudil hydrochloride as well as con- trol agents in treating delayed cerebral vasospasm （CVS） following subarachnoid hemorrhage （SAH）. Methods Forty healthy Japanese white rabbits were selected and randomly divided into 4 groups： 7-day （continual CIV injection of fasudil hydrochloride after the first injection of blood for 7 days）, 5-day （ CIV injection of fasudil hydrochloride for 5 days on the 3rd day after the first injection）, intravenous treatment （iv）, and controls. There were 28 rabbits that underwent 84 cerebral angiographies. The basal artery was obtained, and its pathological changes were observed under the light and electron microscopies. Results Severe CVS occurred in the control group on the 5th and 7th day. CVS due to SAH was significantly allevi- ated after intravertebral artery and intravenous injection. The difference between the intravenous and intra- vertebral artery groups was significant on the 7th day but not on the 5th day. There was no significant difference in the preventive effect between the 5-day and 7-day groups, but this effect differed from the iv group, which was supported by the pathological examinations. Conclusion The effect of CIV injection of fasudil hydrochloride in treating delayed CVS due to SAH at different time points was better than intrave- nous administration.

关 键 词：脑血管痉挛 盐酸法舒地尔 蛛网膜下腔出血 

分 类 号：R743.3[医药卫生—神经病学与精神病学]