脑淋巴引流阻滞降低实验性蛛网膜下腔出血后脑灌注压和基底动脉对乙酰胆碱的反应性

Cerebral lymphatic blockage depresses cerebral perfusion pressure and the reactivity of basilar artery to acetylcholine after experimental subarachnoid hemorrhage

目的探讨脑内物质经淋巴引流途径在蛛网膜下腔出血(SAH)后继发性脑缺血的作用。方法将Wistar大鼠随机分入正常对照组、SAH组、SAH+脑淋巴引流阻滞(CLB)组。用结扎颈部淋巴管并摘除淋巴的方法制作CLB模型,用枕大池两次注血法制作SAH模型;在SAH+CLB组,先制作CLB模型,1 d后制作SAH模型。在术后12 h内检测脑灌注压;于术后3 d观察基底动脉对乙酰胆碱的反应性。结果SAH组于枕大池注入动脉血后脑灌注压显著而持续下降,SAH+CLB组脑灌注压下降更加显著。表面滴加乙酰胆碱后,SAH组基底动脉舒张百分率显著小于正常对照组,SAH+CLB组基底动脉舒张百分率显著小于SAH组。结论脑淋巴引流途径阻滞可降低SAH后脑灌注压和基底动脉对乙酰胆碱的反应性,提示该途径在SAH后继发性脑缺血损伤中可能发挥内源性保护作用。

Objective:To investigate the possible role of cerebral lymphatic drainage pathway in the process of secondary cerebral ischemic injury following subarachnoid hemorrhage(SAH).Methods: Wistar rats were divided into normal control,SAH,and SAH+CLB groups.Cerebral lymphatic blockage(CLB) models were produced by removal of cervical lymphatic nodes after obstruction of the tubes,and SAH models were produced using a double cisternal injection of autologus arterial blood.In SAH+CLB group,SAH was induced 1d after pro...