CAJ | 학술논문

目的探讨人组织激肽释放酶(HTK)对兔蛛网膜下腔出血(SAH)后症状性脑血管痉挛(CVS)的影响.方法建立兔CVS模型,将双侧颈总动脉结扎2周后存活的兔子随机分为4组:假手术(Sham)组、蛛网膜下腔出血(SAH)组、HTK组,尼莫地平(ND)组.除Sham组外,其余3组动物行二次枕大池注血.后两组于第1次注血后第1～5天分别经静脉给HTK或ND.所有动物于第6天处死.用三维CT血管造影(3D-CTA)观察各组注血前后基底动脉直径变化,并对比基底动脉病理改变.结果与SAH组相比,HTK组基底动脉痉挛不明显(P<0.01),光镜见基底动脉病理改变不明显,ND组基底动脉痉挛无明显缓解(P>0.05).结论 SAH后早期应用人组织激肽释放酶对兔脑血管痉挛具有明显的改善作用.
목적 탐토인조직격태석방매(HTK)대토주망막하강출혈(SAH)후증상성뇌혈관경련(CVS)적영향.방법 건립토CVS모형,장쌍측경총동맥결찰2주후존활적토자수궤분위4조:가수술(Sham)조、주망막하강출혈(SAH)조、HTK조,니막지평(ND)조.제Sham조외,기여3조동물행이차침대지주혈.후량조우제1차주혈후제1～5천분별경정맥급HTK혹ND.소유동물우제6천처사.용삼유CT혈관조영(3D-CTA)관찰각조주혈전후기저동맥직경변화,병대비기저동맥병리개변.결과 여SAH조상비,HTK조기저동맥경련불명현(P<0.01),광경견기저동맥병리개변불명현,ND조기저동맥경련무명현완해(P>0.05).결론 SAH후조기응용인조직격태석방매대토뇌혈관경련구유명현적개선작용.
Objective To study the effects of human tissue kallikrein (HTK)on symptomatic cerebral vasospasm (CVS) after subarachnoid hemorrhage (SAH).Methods Forty rabbits underwent occlusion of bilateral carotid.Two weeks later the 28 surviving rabbits were randomly divided into to 4 groups:shamed-operation group ( n = 8) undergoing injection of normal saline into the cisterna magna on day 1 and day 3,SAH group ( n = 6) undergoing injection of nonheparinized autologous arterial blood into the cisterna magna,HTK therapy group ( n = 6) undergoing blood injection into the cistema magna and then injection of HTK via ear marginal vein daily for 3 days,and nimodipine (ND) therapy group ( n = 6) undergoing blood injection into the cisterna magna and then injection of ND via ear marginal vein.3-dimension -CT angiography (3-D CTA) was used to measure the basilar artery diameter on Do and D5.On D6 the rabbits were killed with their basilar arteries taken out to undergo light microscopic examination. Results Blood could be seen in the basis cephalic of the 3 groups undergoing blood injection.3-D CTA showed that arteriospasm was seen in the SAH and ND groups but not in the HTK group.Microscopy showed obvious pathological changes in basilar artery in the SAH and ND groups but not in the HTK group.Conclusion HTK given early after SAH effectively alleviates the symptomatic cerebral vasospasm.