Protective effects of cilostazol against transient focal cerebral ischemia and chronic cerebral hypoperfusion injury

Cilostazol increases intracellular cyclic adenosine monophosphate (cyclic AMP) levels by inhibiting type III phosphodiesterase. It was approved by the Food and Drug Administration for the treatment of intermittent claudication. Its principal actions include inhibition of platelet aggregation, antithrombotic action in cerebral ischemia, and vasodilation, mediated by increased cyclic AMP levels. In a multicenter, randomized, placebo-controlled, double-blind clinical trial, cilostazol has been shown to protect patients from recurrent cerebral infarction. It has been recently suggested that cilastozol could be useful in the treatment of transient focal cerebral ischemic injury. Beneficial effects of cilostazol in cerebral ischemic infarction and edema formation has been confirmed in rats by the magnetic resonance imaging (MRI). The preventive effect was ascribed to cAMP-dependent protein kinase (PKA)-coupled maxi-K channel activation with additional antioxidant and poly(adenosine diphosphate [ADP]-ribose) polymerase inhibitory actions. Most recently, cilostazol has been shown to prevent vacuolation and rarefaction in the white matter of the rats subjected to chronic cerebral hypoperfusion in association with suppression of astrocyte and microglial activation. Taken together, recent experimental studies with cilostazol showed promising results in cerebral ischemia and chronic cerebral hypoperfusion.     

High-dose aspirin is neuroprotective in a rat focal ischemia model

Acetylsalicylic acid (ASA) is neuroprotective through various pharmacological action sites. We used a temporary middle cerebral artery occlusion (tMCAO) model in 56 Wistar rats to assess whether repeated ASA injections at 30 min, 6 h, 1, 2, 3, and 4 days after stroke onset are neuroprotective. Animals were sacrificed 5 days after MCAO; infarct size was analyzed with 2,3,5-triphenyltetrazolium chloride staining. As compared to saline (164+/-13 mm(3), n=14), only repeated injections of 40 mg/kg ASA (79+/-18 mm(3), n=14, P=0.0029), but not of 20 mg/kg ASA (129+/-19 mm(3), n=15), reduced infarct volume significantly. No significant change was noted with 40 mg/kg ASA injected only once at 30 min after MCAO (117+/-16 mm(3), n=13).     

神经保护剂单药和联合应用对大鼠脑缺血后梗死体积的影响

目的探讨不同类型神经保护剂联合应用是否较单一应用对局灶性脑缺血有更好的保护作用。方法采用线栓法制作大鼠大脑中动脉闭塞(MCAO)模型,分为尼莫地平(NDP)组、硫酸镁(MgSO4)组、Mk-801(dizocilpine)组、还原型谷胱甘肽(GSH)组、环磷酰胺(Cyclophosphanide)组、联合组和对照组,观察缺血后6小时和24小时梗死体积的变化。结果缺血后6小时和24小时联合组梗死体积明显减小,与单一用药各组相比有显著性差异(P<0.05)。结论神经保护剂联合应用疗法对脑缺血保护作用较单一用药明显增强。     

The effect of high-dose albumin therapy on local cerebral perfusion after transient focal cerebral ischemia in rats

We have shown that high-concentration albumin therapy is markedly neuroprotective in focal cerebral ischemia. The present study was conducted to ascertain the degree to which hemodynamic alterations are responsible for this therapeutic effect. Normothermic, physiologically regulated male Sprague–Dawley rats received a 2-h period of middle cerebral artery occlusion (MCAo) by insertion of an intraluminal suture coated with poly-l-lysine. Albumin (25% human serum albumin solution) or vehicle (0.9% sodium chloride) was administered intravenously at a dose of 1% of body weight immediately after suture withdrawal following 2-h MCAo. Local cerebral blood flow (LCBF) was measured autoradiographically with after 1 h of recirculation. Novel image-processing methods were used to compare average LCBF data sets against previously obtained infarction-frequency data on a pixel-by-pixel basis. Albumin therapy reduced mean hematocrit by 42% but produced no other systemic alterations. Pixel-based histopathological analysis revealed large, consistent cortical and subcortical infarcts in saline-treated rats with MCAo; albumin therapy reduced mean cortical infarct volume by 85%. Within regions showing albumin-associated neuroprotection, numbers of pixels having LCBF in the upper ischemic-core flow range (0.12–0.24 ml g⁻¹ min⁻¹) were reduced by 8.6-fold by albumin therapy when compared to saline-treated rats; and numbers of pixels with LCBF in the lower penumbral flow range (0.24–0.36 ml g⁻¹ min⁻¹) were reduced by 3.1-fold in albumin-treated rats (p=0.04 by repeated-measures analysis of variance). Analysis of the [albumin–saline] 3-dimensional difference-image data set revealed a circumferential zone of statistically significant albumin-associated LCBF increase within the posterior portion of the ischemic hemisphere, surrounding the core-region of prior ischemia. Thus, high-concentration albumin therapy improves local perfusion to regions of critical LCBF reduction. The spatial extent of this LCBF effect, however, appears too small to account fully for the marked neuroprotective efficacy of this therapy. We suggest that other, non-hemodynamic mechanisms may also be contributory.     

氯吡格雷与阿司匹林联用治疗脑梗死的效果观察

目的观察氯吡格雷联合阿司匹林治疗脑梗死的临床效果。方法选取脑梗死患者70例,随机分为观察组(35例)和对照组(35例),观察组给予氯吡格雷联合阿司匹林治疗,对照组单独给予阿司匹林治疗,观察2组总有效率及治疗前后实验室指标。结果观察组治疗后基本痊愈6例,显效17例,有效10例,总有效率94.29%;对照组基本痊愈2例,显效11例,有效8例,总有效率60.00%,观察组总有效率明显高于对照组,差异有统计学意义(P0.05)。治疗30d后观察组血小板(PLT)、血小板聚集率(PA)及全血黏度(高切、低切)指标均明显低于对照组,差异有统计学意义(P0.05)。结论氯吡格雷联合阿司匹林治疗脑梗死临床效果显著,值得临床推广。     

The neuroprotective effect of glial cell line-derived neurotrophic factor in fibrin glue against chronic focal cerebral ischemia in conscious rats

Glial cell line-derived neurotrophic factor (GDNF) is a transforming growth factor-beta which has shown beneficial effects in rats after acute focal cerebral ischemia (FCI). To study the effects of GDNF on chronic FCI injury in conscious rats, we used fibrin glue (GDNF-fibrin glue) and fibrin glue free (GDNF-only)-GDNF topically applied to the ischemic brain after right middle cerebral artery (MCA) ligation. Infarct brain volume and functional motor deficits were measured before and after FCI injury. After FCI injury induced by right MCA ligation, rats were randomly assigned to one of four treatment groups: (a) sham, (b) control, (c) topically applied GDNF (1 mug)-only, and (d) topically applied GDNF (1 mug)-fibrin glue. The degree of ischemic brain injury was estimated by infarct volume of right MCA territory at 4 weeks after occlusion. The functional motor deficits were quantified with rotarod test and grasping power test once a week. Topically applied GDNF-fibrin glue at infarct brain tissue after 4 weeks FCI injury significantly reduced the total infarct volume by 44.3% and 36%, respectively, compared to that of control group and GDNF-only group. The mean latencies for rats to stay on the rotarod were 55.0%, 50.3%, and 92.2% (P < 0.05 vs. control group and GDNF-only group) of baseline, respectively, in the control, GDNF-only, and GDNF-fibrin glue groups at the end of the 1st week after FCI injury but 75.3%, 67.3%, and 106.6% (P < 0.05 vs. control group and GDNF-only group) of baseline at the end of the 4th week after FCI injury. The mean values of grasping power were 78.7%, 71.7%, and 101.2% (P < 0.05 vs. control group and GDNF-only group) of baseline, respectively, in the control, GDNF-only, and GDNF-fibrin glue groups at the end of 1st week after FCI injury but 89.6%, 97.6%, and 120.7% (P < 0.05 vs. control group) of baseline at the end of 4th week after FCI injury. These results indicate that GDNF-fibrin glue not only reduced the total infarct volume after FCI injury but can also improve motor deficits after FCI injury. We concluded GDNF-fibrin glue could facilitate delivery of GDNF to the damaged brain tissue with subsequent reduction of ischemic brain injury accompanied by enhancing functional recovery in rats with chronic FCI injury.     

Mild postischemic hypothermia limits cerebral injury following transient focal ischemia in rat neocortex

Intraischemic mild hypothermia has been shown to attenuate cerebral infarction occurring after transient focal ischemia. In contrast, the capacity of mild hypothermia to provide a protective effect when administered postischemically has not been clearly defined for transient focal events such as occur in many types of stroke. The present study addressed this issue by investigating the influence of timing and duration of mild hypothermia on cerebral infarction in a rat model of reversible focal ischemia. Sprague-Dawley rats (n = 45) were subjected to 3 h of focal neocortical ischemia by occluding reversibly one middle cerebral artery and both carotid arteries. Mild hypothermia was established after reperfusion and maintained for brief (1 h) or prolonged (21 h) periods. Animals were sacrificed 24 or 48 h after ischemia. A significant reduction (32%) in the volume of infarction was obtained when hypothermia was established immediately after reperfusion and maintained for a prolonged (21 h) period. In contrast, immediate but brief (1 h) hypothermia did not reduce infarction volume. Delaying hypothermia until 30 min post reperfusion and maintaining it for 21 h reduced infarction volume by 22%; however, this effect did not achieve statistical significance. These findings demonstrate that mild postischemic hypothermia is capable of protecting against cerebral injury following transient focal ischemia but that prolonged hypothermia is required to achieve this effect. These findings are consistent with increasing evidence that the window of therapeutic opportunity after transient focal ischemia is rather brief and that critical mechanisms involved in this form of ischemic injury remain activated over a rather lengthy postischemic interval.     

Post-ischemic RSR13 amplifies the effect of dizocilpine on outcome from transient focal cerebral ischemia in the rat

In a recent study of focal cerebral ischemia in rats, pre-ischemic administration of the synthetic allosteric hemoglobin modifier RSR13 (2-[4-[[3,5-dimethylanilino) carbonyl] methyl] phenoxy]-2-methylproprionic acid) reduced cerebral infarct size when combined with the NMDA receptor antagonist dizocilpine (MK-801) but not when given alone. We hypothesized that post-ischemic RSR13 administration would enhance neuroprotection afforded by NMDA receptor antagonism in a rat model of transient middle cerebral artery occlusion (MCAO). Fasted normothermic Wistar rats underwent 75 min of temporary MCAO. At onset of reperfusion, rats randomly received: (1) 0.9% NaCl (vehicle) i.v. alone (n=16); (2) 0.9% NaCl+dizocilpine (0.25 mg/kg) i.v. (n=16); or (3) RSR13 (150 mg/kg)+dizocilpine (0.25 mg/kg) i.v. (n=17). Seven days later, neurologic deficit and cerebral infarct size were determined. Dizocilpine alone compared to vehicle reduced mean+/-S.D. subcortical (52+/-24 mm(3) vs. 122+/-64 mm(3), P=0.003) and cortical (35+/-35 mm(3) vs. 125+/-72 mm(3), P=0.00074) infarct volumes. When compared to dizocilpine alone, the combination of RSR13+dizocilpine further reduced subcortical (37+/-14 mm(3) vs. 52+/-24 mm(3), P=0. 034) and cortical (8+/-19 mm(3) vs. 35+/-35 mm(3), P=0.018) infarct size. RSR13+dizocilpine improved neurologic scores vs. either dizocilpine alone (P=0.0014) or vehicle (P=10(-7)). The combination of NMDA receptor antagonism and a RSR13 mediated rightward shift of the oxy-hemoglobin dissociation curve improved outcome from MCAO. Because this occurred after reperfusion, our results suggest that the post-ischemic brain continues to suffer from hypoperfusion defects, which are amenable to therapy by enhanced O(2) delivery. The results also support the concept that neuroprotective strategies, which combine drugs with different mechanisms of action, may yield cumulative benefits.     

急性期升高血压对大鼠局灶性脑缺血损伤的保护作用

目的　探讨升高血压对急性期局灶性脑缺血损伤的保护作用。方法　线栓法制作大鼠局灶性脑缺血模型 ,利用 TTC染色法测定脑梗死体积 ,尼氏染色光镜观察缺血中心边缘区脑组织病理改变 ,电镜观察该区脑组织的超微结构。结果　缺血后 3h内升压治疗能够明显缩小梗死体积 (P<0 .0 5 ) ,光镜观察发现缺血中心区周围存在神经元变性移行区 ,电镜观察发现缺血 4 h后缺血中心边缘区神经元明显固缩、毛细血管腔严重受压 ,而缺血 3h升压组上述部位神经元及毛细血管损伤明显减轻。结论　急性期升高血压对局灶性脑缺血损伤具有明显保护作用。     

Normobaric hyperoxia retards the evolution of ischemic brain tissue toward infarction in a rat model of transient focal cerebral ischemia

Objectives: Oxygen therapy has been long considered a logical therapy for ischemic stroke. Our previous studies showed that normobaric hyperoxia (normobaric hyperoxia (NBO), 95% O₂ with 5% CO₂) treatment during ischemia reduced ischemic neuronal death and cerebromicrovascular injury in animal stroke models. In this study, we studied the effects of NBO on the evolution of ischemic brain tissue to infarction in a rat model of transient focal cerebral ischemia.

Methods: Male Sprague-Dawley rats were given NBO (95% O₂) or normoxia (21% O₂) during 90-min filament occlusion of the middle cerebral artery (MCAO), followed by 3 or 22.5 h of reperfusion. 2,3,5-triphenyltetrazolium chloride (TTC) staining was used to evaluate the longitudinal evolution of tissue infarction.

Results： In normoxic rats, MCA-supplied cortical and striatal tissue was infarcted after 90-min MCAO with 22.5 h of reperfusion. NBO-treated rats showed a 61.4% reduction in infarct size and tissue infarction mainly occurred in the ischemic striatum. When infarction was assessed at an earlier time point, i.e. at 3 h of reperfusion, normoxic rats showed significantly smaller but mature infarction (no TTC staining, white color), with the infarction mainly occurring in the striatum. Unexpectedly, NBO-treated rats only showed immature lesion (partially stained by TTC, light white color) in the ischemic striatum, indicating that NBO treatment also retarded the process of neuronal death in the ischemic core. Of note, NBO-preserved striatal tissue underwent infarction after prolonged reperfusion.

Conclusions： Our results demonstrate that NBO treatment given during cerebral ischemia retards the evolution of ischemic brain tissue toward infarction and NBO-preserved cortical tissue survives better than NBO-preserved striatal tissue during the phase of reperfusion.     

大鼠短暂局灶性脑缺血再灌注后核转录因子-kB的表达

目的　研究核转录因子 - k B(NF- k B)在局灶性脑缺血再灌注中的动态表达规律及其作用。方法　采用线栓法建立大鼠局灶性脑缺血再灌注模型。应用细胞免疫组织化学法分析 NF- k B的移位 ,采用 Western- blot法检测脑组织中核 NF- k B的表达量。结果　局灶性脑缺血再灌注后 NF- k B明显从细胞浆移位于细胞核 ,核 NF- k B的表达量显著增加 (P<0 .0 1)。结论　局灶性脑缺血再灌注能够引起 NF- k B的表达增加 ,进一步产生炎症和免疫反应 ,从而参与了脑缺血再灌注损伤的发病机制     

Lipopolysaccharide pre-treatment induces resistance against subsequent focal cerebral ischemic damage in spontaneously hypertensive rats

Ischemic tolerance was induced in spontaneously hypertensive rats (SHR) by injection of a single dose of lipopolysaccharide (LPS) (0.9 mg/kg, i.v.) 1–7 days prior to permanent middle cerebral artery occlusion (MCAO). Infarct volume, evaluated 24 h after MCAO, was significantly reduced by LPS administration 2, 3 or 4 days prior to MCAO (22.8, 25.9 and 20.5%, respectively). The beneficial effect of LPS pre-treatment was completely nullified by concurrent administration of TNFbp. On this basis, the tolerance to ischemia induced by LPS is likely to be mediated by TNF-α.     

Microvascular structure after embolic focal cerebral ischemia in the rat

OBJECTIVES: We analyze morphological alterations of cerebral neovascularization after stroke using a new 3D imaging software program. METHODS: Male Wistar rats underwent unilateral embolic middle cerebral artery occlusion (MCAo) by a single fibrin rich clot. Subjects were sacrificed from 1 to 28 days post infarct. Vessel perimeters were measured on coronal sections stained with endothelial cell-specific antibody to von Willebrand's factor. Vessel segment lengths, diameters and number of vessels were analyzed on cerebral microvessels perfused with FITC-dextran 14 days after ischemia using LSCM and a 3-D vessel quantification program. RESULTS: The mean number of microvessels with enlarged perimeters significantly increased in the ipsilateral cortex at day 7 when compared to the contralateral cortex (29.7+/-14.7 vs. 3.7+/-2.5, P<0.05). Subsequently, differences in the number of microvessels with enlarged perimeters decreased on days 14 and 28. Fourteen days post-MCA occlusion, microvessel segment length (15.0 vs. 26.0 microm, P<0.05) and diameter (3.14 vs. 3.75 microm, P<0.05) significantly decreased in the ipsilateral hemisphere when compared to the contralateral hemisphere, respectively. Furthermore, the mean total number of these smaller microvessels increased in the ipsilateral hemisphere (57.33+/-14.5 vs. 32.22+/-11.7, P<0.05). CONCLUSIONS: Focal cerebral ischemia induces morphological changes (early dilated microvessels followed by decreased microvessel segment length and diameter) that are consistent with newly generated microvessels.     

Inhibition of Na/H exchanger reduces infarct volume of focal cerebral ischemia in rats

Activation of Na⁺/H⁺ exchanger (NHE) may have an important role in ischemic cell death by means of intracellular overload of Na⁺ and Ca²⁺. Recent evidence has suggested that inhibitors of NHE have protective effects on myocardial ischemia both in vivo and in vitro. In this study, we tested the hypothesis that FR183998, an inhibitor of NHE, reduces infarct volume produced by focal cerebral ischemia in rats. We used 20 male spontaneously hypertensive rats. Either FR183998 (1 mg/kg; n=10), or vehicle (n=10) was given intravenously to the rats and the distal middle cerebral artery of each animal was occluded using a photothrombotic technique. We measured regional cerebral blood flow using laser-Doppler flowmetry throughout the experiments. After 3 days, infarct volume was measured in each animal group. To estimate the brain edema, we also calculated the cortical volume in both hemispheres. The infarct volume in the FR183998-treated group (82±8 mm³, mean±S.E.M.) was significantly smaller than that in the control group (115±12 mm³) (P=0.034). The cortical volume of the occluded side in the FR183998-treated group (359±7 mm³) tended to be smaller than that in the control group (378±9 mm³) (P=0.116). The regional cerebral blood flow and physiological variables during ischemia were not significantly different between the two groups throughout the experiments. These results suggest that inhibition of NHE by FR183998 may have beneficial effects in reducing infarct volume and brain edema during cerebral ischemia. Thus, NHE may play an important role in the development of neuronal damage during acute cerebral ischemia.     

CD47 gene knockout protects against transient focal cerebral ischemia in mice

CD47 is a cell surface glycoprotein that helps mediate neutrophil transmigration across blood vessels. The present study was performed to determine whether absence of the CD47 gene decreases focal ischemic brain damage. Mice were subjected to 90 min middle cerebral artery occlusion. CD47 knockout mice were compared against matching wildtype mice. CD47 expression was checked by Western blotting. Infarct volume and ischemic brain swelling were quantified with cresyl violet-stained brain sections at 24 and 72 h after ischemia. The tight junction protein claudin-5 was detected by imunohistochemistry. Two surrogate markers of neuroinflammation, brain levels of matrix metalloproteinase-9 (MMP-9) and infiltration of neutrophils, were assessed by immunohistochemistry. Western blots confirmed that CD47 was absent in knockout brains. Ischemia did not appear to upregulate total brain levels of CD47 in WT mice. In CD47 knockout mice, infarct volumes were reduced at 24 and 72 h after ischemia, and hemispheric swelling was decreased at 72 h. Loss of claudin-5 was observed in ischemic WT brain. This effect was ameliorated in CD47 knockout brains. Extravasation of neutrophils into the brain parenchyma was significantly reduced in CD47 knockout mice compared to wildtype mice. MMP-9 appeared to be upregulated in microvessels within ischemic brain. MMP-9 levels were markedly lower in CD47 knockout brains compared to wildtype brains. We conclude that CD47 is broadly involved in neuroinflammation, and this integrin-associated-protein plays a role in promoting MMP-9 upregulaton, neutrophil extravasation, brain swelling and progression of acute ischemic brain injury.     

Neuroprotective effect of morroniside on focal cerebral ischemia in rats

Cornus officinalis Sieb. et Zucc., known as Shan-zhu-yu in Chinese, has been used to treat cerebrovascular disease and diabetes in Traditional Chinese Medicine for a long time and morroniside is the main component of Shan-zhu-yu. In this study, we examined whether morroniside could protect ischemia/reperfusion-induced brain injury by minimizing oxidative stress and anti-apoptosis. Morroniside was intragastrically administered to rats in doses of 30, 90 and 270 mg/kg/day, starting 3 h after the onset of middle cerebral artery occlusion. The behavioral test was performed by using the Zea-Longa scores, Prehensile Traction score and Ludmila Belayer score. Rats were sacrificed 3 days after ischemia occurred. The infarction volume of brain was assessed in the brain slices stained with 2,3,5-triphenyl tetrazolium chloride. Cortex tissues were also used for determination of malondialdehyde levels, glutathione levels and superoxide dismutase. The treatment with morroniside significantly improved Zea-Longa scores and Prehensile Traction score at the doses of 30, 90 and 270 mg/kg, increased Ludmila Belayer score and reduced the infarction volume at the doses of 90 and 270 mg/kg. Morroniside (30, 90 and 270 mg/kg) treatment significantly decreased the level of malondialdehyde and caspase-3 activity by colorimetric analysis in ischemic cortex tissues. Morroniside (270 mg/kg) treatment significantly increased the content of glutathione, enhanced the activity of superoxide dismutase, but decreased the caspase-3 expression by Western-blot analysis in ischemic cortex tissues. These findings demonstrated that morroniside could notably protect the brain from damage induced by focal cerebral ischemia which might be related to morroniside antioxidant and anti-apoptotic properties in the brain.     

不同剂量阿司匹林治疗脑梗死的疗效及对血清C反应蛋白的影响

目的探讨不同剂量阿司匹林治疗脑梗死的临床疗效及对于血清C反应蛋白(CRP)的影响。方法收集我院收治的脑梗死患者60例为脑梗死组,随机分为A组、B组和C组各20例。分别应用50mg/d、100mg/d及300mg/d阿司匹林治疗,选择同期健康体检者20例作对照组(D组),比较A、B、D组的临床疗效,并与D组比较CRP水平。结果脑梗死组血清CRP水平显著高于D组(P0.05),治疗后A、B、C组CRP均显著降低,且C组显著低于A、B组(P0.05);治疗后A、B、C组NIHSS评分均显著降低(P0.05),且C组显著低于A、B组(P0.05);C组总有效率为90.0%,显著高于A组的60.0%和B组的75.0%(P0.05);3组不良反应无明显差异(P0.05)。结论阿司匹林治疗脑梗死可显著改善患者的神经功能并降低血清CRP水平,疗效显著,且其疗效存在剂量依赖性,大剂量疗效显著且安全可靠,值得推广应用。     

香港远志提取物对局灶性脑缺血大鼠脑保护作用与作用机制

目的探讨香港远志提取物对局灶性脑缺血大鼠脑保护作用与机制。方法线栓法制备SD大鼠大脑中动脉闭塞(MCAO)模型,随机分4组:假手术组、模型组及治疗A、B组。治疗组按设定方式给药,假手术组、模型组给1%吐温溶液。观察术后24h神经功能缺损评分(NBDS)、脑梗死体积(IV)、血清神经元烯醇化酶(NSE)及神经元凋亡、Bcl-2、Bax表达。结果与假手术组比较,模型组和治疗组NBDS、IV、NSE、神经元凋亡及Bcl-2、Bax显著增高、Bcl-2/Bax显著降低(P<0.05)。与模型组比较,治疗组NBDS、IV、NSE及神经元凋亡、Bax显著降低、Bcl-2、Bcl-2/Bax显著增高(P<0.05),治疗组间数据亦有显著差异(P<0.05)。结论香港远志提取物预处理,对局灶性脑缺血大鼠脑神经有保护作用,机制可能是促进Bcl-2、抑制Bax表达,上调Bcl-2/Bax比值,阻止神经元凋亡。     

阿司匹林抵抗对大动脉粥样硬化性脑梗死复发的影响

目的 观察阿司匹林抵抗(aspirin resistance,AR)对大动脉粥样硬化性脑梗死(large artery atherosclerosis cerebral infarction,LAACI)复发的影响。方法 选择阳东县人民医院首次发生LAACI患者269例,入院后即服用阿司匹林200mg,在7～10d后利用比浊法检测血小板聚集率,分为AR组40例,阿司匹林敏感组(aspirin sensitivity,AS)229例,进行随访6～12个月; 根据脑梗塞复发的情况分为大动脉粥样硬化复发(large artery atherosclerosis recurrence,LAAR)组38例和大动脉粥样硬化无复发(not large artery atherosclerosis recurrence,NLAAR)组231例,观察AR患者的危险因素,同时观察LAAR与AR之间的关系。结果 单因素分析中AR组的LAAR显著高于AS组(34.2% vs 11.7%,P=0.000),跟NLAAR组比较LAAR组患糖尿病、AR、年龄较大的比例均明显升高(P<0.05或0.01); 多因素分析中LAAR与AR明显相关(OR=4.692,95% CI=1.052～15.675,P=0.005)。结论 AR是LAAR的独立危险因素,能够增加LAAR的风险。     

Risperidone attenuates brain damage after focal cerebral ischemia in vivo

Since their introduction, atypical neuroleptic agents have been discovered to have some beneficial effects beyond their effectiveness as neuroleptic drugs. Among these initially unexpected effects are their potential effects as mood stabilizers in bipolar disorder and their efficacy in improving long-term outcome in schizophrenia. These effects recently raised the question whether these drugs may also have some neuroprotective effect in the brain. To examine this matter, in this study we evaluated the neuroprotective effect of risperidone after permanent focal cerebral ischemia. Anaesthetized male C57BL/6j mice were submitted to permanent thread occlusion of the middle cerebral artery (MCA). Risperidone (0.1, 1 or 10 mg/kg) or vehicle was applied intraperitoneally just after permanent ischemia. Twenty-four hours after permanent ischemia, brain injury was evaluated by triphenyltetrazolium chloride staining (TTC). Risperidone (0.1, 1 and 10 mg/kg) showed significant neuroprotection after permanent focal cerebral ischemia.