尼莫地平对兔症状性脑血管痉挛的保护效应

Effects of nimodipine on rabbits with symptomatic cerebral vasospasm

目的 探讨尼莫地平对兔症状性脑血管痉挛继发脑损伤的保护效应.方法 双侧颈总动脉结扎后无神经症状日本大耳白兔24只,采用数字随机法随机分为3组（n=8）：假手术（Sham）组、蛛网膜下腔出血（SAH）组、尼莫地平（ND）组：SAH＋静脉输注尼莫地平0.1 mg/kg,连续静脉给药5 d.每组兔子蛛血前后每日进行食量测定和神经功能评分,分别在第一次蛛血前1 d及后5 d行3D-CTA造影,并在最后一次造影后甲醛灌注固定取基底动脉行HE染色与电镜观察.结果 SAH后神经功能评分明显升高,基底动脉发生明显痉挛,光镜与电镜均提示基底动脉出现凋亡样改变.尼莫地平对痉挛的基底动脉无扩张作用,但可以减少神经功能症状的出现,减轻基底动脉病理学改变.结论 尼莫地平不能扩张痉挛的基底动脉,但能明显地改善兔症状性脑血管痉挛继发脑损伤的神经症状.

Objective To investigate the effects of nimodipine on symptomatic cerebral vasospasm in rabbits. Methods Twenty four japanese white rabbits which ligation of bilateral common carotid arteries and no neurological deficits were randomized to sham-operation, subarachnoid hemorrhage （SAH） and nimodipine which injected of nimodipine 0.1 mg/kg, continuous vein administration 5 day. The behavior scores, neurological scores were observed everyday and cerebral angiography changes were measured twice by 3D-CTA,and basilar artery was removed for pathological examination after last CTA examination. Results In SAH group , The basilar artery were significantly vasoconstrictive on 5 days, neurological scores were increased, and the basilar artery was found apoptosis-like changes under light microscopic and electron microscope. Nimodipine group could not dilated the basilar artery arteriospasm after SAH, but it could attenuate neurological deficit,and obviously alleviate the pathological changes of basilar artery. Conclusion Nimodipine could not vasodilation of basilar artery in SCVS, but obviously could alleviate neurological changes and pathological changes of basilar artery. in rabbits with symptomatic cerebral vasospasm.