尼莫地平和别嘌呤醇对完全性脑缺血再灌注期间脑组织代谢的影响

Effects of nimodipine and allopurinol on canine cerebral biochemical metabolism after complete cerebral ischemia and rcpcrfusion

２４只犬随机分为四组：单纯缺血组（Ⅰ）、尼莫地平组（Ｎ）、别嘌吟醇组（Ａ）以及两种药物复合治疗组（Ｃ）。采用闭塞双侧颈总动脉、椎动脉伴体循环控制性降压全脑缺血动物模型，缺血时限为２０分钟，观察再灌注２小时内矢状窦血乳酸脱氢酶、酸碱平衡及脑组织糖代谢。结果显示，缺血后再灌注期间矢状窦ＰＳＳＨ值显著降低，ＰＳＳＣＯ２明显增高，乳酸脱氢酶（ＬＤＨ）活性增加。各治疗组各项指标均有不同程度的改善，以尼莫地平及复合治疗组最为显著。再灌注期间，动脉、矢状窦血糖含量显著增加，达对照值２倍。乔灌注初期，脑组织糖摄取及糖耗量明显降低。随时间延长，脑组织糖摄取及糖耗量明显增加。提示尼莫地平、别瞟吟醇对缺血后再灌注期间脑组织酸碱平衡及糖代谢具有一定的治疗效应。

The experiment was undertaken to evaluate the effects of allopurinol (AIP) and nimodipine (NMD) on cerebral glucose metabolism during cerebral resucitation. The modle of complete cerebral ischenlia(CCI) was induced by ligation of bilateral common cariods and vertabral arteries under controlled hypotentlon. Twenty-four mongrel healthy dogs,after having suffered from CCI for 20 mins,were randomly allocated to intravenously receiving normal saline as control (group I ), ALP 20mg/kg (group A ). NMD 20μg/kg (group N ),or combination of ALP and NMD(group C ), at the same time as reperfusion(RP) began, respectively. The blood samples in sagittal sinus (SS) were taken to measure pH .partial pressure of CO2 (PssCO2 ),activity of lactate dehydronase (LDH ) and plasma glucose level (PGL),and arterial blood samples were only for determining PLG, before CCI, 5, 15, 30, 60 and 120 mlns after RP,separately. Following RP,pH decreased markedly in group I,only at sib min in group A and C,and at 120th min in group N (P<0. 05);PssCO2 increased in group I (P<0. 05 ) and kept stable in group A, N and C (P<0. 05);activity of LDH rose at 60th and 120th min in all groups (P<0. 05 ); PGLs in artery and SS were ascended in all groups (P<0. 05 ). As compared with those in group I,after 60 and 120 mlns of RP,pH Increased significantly in group C and activity of LDH reduced in group N and C (P<0. 05);after 120mins of RP,the PGL in SS and cerebral glucose metabolic rate went down obviously in group C and the difference in PGL between artery and SS went up in group A and C (P<0. 05). These suggest that during cerebral resucitation after CCI,intravenous combination of NMD and ALP produces more degrees of improvements of cerebral acid-base balance and glucose metabolism,than either component does.