脑池内局部应用尼卡地平多聚体缓释微球治疗脑血管痉挛的实验研究

目的 研究脑池内注入NC -PLGA缓释微球对脑血管痉挛的治疗作用.方法 采用枕大池二次注血法制作兔蛛网膜下腔出血模型.分别采用脑池内注入NC -PLGA微球和尼卡地平的方法治疗脑血管痉挛.应用经颅多普勒技术测基底动脉的血流速度,脑血管造影测量基底动脉直径,光镜和电镜行病理检查,观察基底动脉的形态学变化,评价脑血管痉挛的严重程度.结果 脑池内注入NC - PLGA微球和尼卡地平都能降低基底动脉的血流速度(P＜0.01),基底动脉的直径明显升高(P＜0.01),并能明显改善血管壁的病理改变,但前者只需一次性注入后者总量的1/4既可达到同样的疗效.结论 经脑池内注入NC -PLGA缓释微球能明显减轻脑血管痉挛的严重程度,并可减轻痉挛血管壁的病理学变化.

Experimental study on treatment of cerebral vasospasm by intracisternal infusion of NC - PLGA microspheres

Objective To study the therapeutic effects of intracisternal infusion of( nicardipine,NC) NC - PLGA microspheres solution on rabbits cerebral vasospasm (CVS) models.Method The primary SAH rabbit models were produced by injecting blood two times through cisterna magna.The CVS rabbit models were treated by intracisternal infusing of NC - PLGA microspheres and Nicardipine solution.The basal arteriospasm was observed with transcranial Doppler.The diameter of basilar artery was measured by cerebral angiography to evaluate the severity of CVS( P ＜ 0.01 ).The pathological changes of basilar artery walls were examined.Results Intracisternal infusion of NC - PLGA microspheres and Nicardipine could reduce the severity of CVS.And they could reduce the obvious morphological changes in the artierial wall of BA.Compared with intracisternal infusion of Nicardipine,using 25％ dose of intracisternal infusion of NC - PLGA microspheres could get the same effect.Conclusions The intracisternal infusion of NC - PLGA microspheres could reverse the severity of CVS and reverse the pathologic changement in the arterial wall.The therapeutic course is simple and complication rate is reduced.The technique with polymer should guide the therapy of cerebral vascular disease to some extent.