L-精氨酸枕大池注射对蛛网膜下腔出血脑血管痉挛的影响

目的:研究L-精氨酸枕大池注射对兔蛛网膜下腔出血后脑血管痉挛的影响及作用机制。方法:采用双侧颈动脉结扎及枕大池二次注血法制造兔蛛网膜下腔出血模型。在蛛血后第4天,以比色法测定血清及脑脊液中NO及脑组织NOS的含量。光镜下测定基底动脉的动脉壁厚度和基底动脉的内径,以其比值作为脑血管痉挛的指标。治疗组分为300μmol及500μmol组,在蛛血后第4天,枕大池持续微泵滴注L-精氨酸,在滴注后再分别测定上述指标。结果:蛛血后第4天,基底动脉的动脉壁厚度和内径的比值明显升高,血清及脑脊液中NO及脑组织NOS的含量降低。在L-精氨酸滴注后,脑血管痉挛缓解。血清及脑脊液中NO及脑组织NOS的含量较对照明显升高。结论:L-精氨酸枕大池注射对兔蛛网膜下腔出血后的血管痉挛具有治疗作用。L-精氨酸可能是通过NO及NOS系统起作用。

The Effect of Continuous Intracisternal L-Arginine Infusion on Experimental Cerebral Vasopasm

Objective: To investigate the effect of contionous intracisternal infusion of L-Arginine in a rabbit SAH model. Methods: The model of SAH was set up by blood given two times percutaneously into the cistern after occlusion of bilateral carotid artery in rabbit. At the fourth day of SAH, concetration of NO in serum and CSF were detected. NOS activity in cerebral tissue was also measured. The media-to radius ration was calculated on basilar artery as an in-dictor of cerebral vasospasm. The therapeutic group was divided into two, 300μmol group and 500μmolgroup. After contionuous intracisternal L-Arginine infusion, The datas mentioned above were detected again. Result: At the fourth day of SAH, concentration of NO in serum and CSF decreased as well as NOS activity in cerebral tissue. The media-to-radius ratio eleved compared with control. After infusion of L-arginine, the Vasospasm was vesolved. The concentration of No in serum and CSF as well as Nos activity in cerebral tissue elevated compared with control. Conclusion: L-Argine treatment may be useful for the resolution of vasospasm. The therapeutic effect of L-Argine might be producted via NO and NOS system.