CAJ | 학술논문

目的探讨不同剂量人组织激肽释放酶(HTK)对兔症状性脑血管痉挛的影响.方法双侧颈总动脉结扎后2周无神经功能障碍的日本大耳白兔40只,体重2.0～2.5 kg,随机分为5组(n=8):对照组(C组)、症状性脑血管痉挛组(V组)和低、中、高剂量HTK组(L组、M组和H组).采用枕大池二次注血法建立兔症状性脑血管痉挛模型,V组于第1次枕大池注血后耳缘静脉注射生理盐水5 ml/d,L组、M组和H组每天分别耳缘静脉注射HTK 0.002 5、0.005 0、0.010 0 PNAU/kg,连续14 d0于枕大池注血前1 d(T_1)及注血后每天评价神经功能并记录进食量,于T_1及枕大池第1次注血后5、7、14 d(T_(2～4))时采用三维CT血管造影测定基底动脉直径,第15天时取基底动脉观察病理学结果.结果与C组比较,V组低进食量和神经功能障碍发生率升高(P＜0.05);与V组比较,L组、M组和H组低进食量与神经功能障碍发生率降低,T_3时基底动脉直径增加,H组T_4时基底动脉直径增加(P＜0.05);与T_1时比较,V组T_(2,3)时基底动脉直径缩短(P＜0.05),L组、M组和H组T_(2,3)时基底动脉直径差异无统计学意义(P＞0.05),T_4时基底动脉直径增加(P＜0.05);与L组和M组比较,H组T_4时基底动脉直径增加(P＜0.05).结论耳缘静脉注射HTK(0.002 5～0.010 0 PNAU/kg,连续14 d)可改善兔症状性脑血管痉挛,其效应呈剂量依赖性.
목적 탐토불동제량인조직격태석방매(HTK)대토증상성뇌혈관경련적영향.방법 쌍측경총동맥결찰후2주무신경공능장애적일본대이백토40지,체중2.0～2.5 kg,수궤분위5조(n=8):대조조(C조)、증상성뇌혈관경련조(V조)화저、중、고제량HTK조(L조、M조화H조).채용침대지이차주혈법건립토증상성뇌혈관경련모형,V조우제1차침대지주혈후이연정맥주사생리염수5 ml/d,L조、M조화H조매천분별이연정맥주사HTK 0.002 5、0.005 0、0.010 0 PNAU/kg,련속14 d0우침대지주혈전1 d(T_1)급주혈후매천평개신경공능병기록진식량,우T_1급침대지제1차주혈후5、7、14 d(T_(2～4))시채용삼유CT혈관조영측정기저동맥직경,제15천시취기저동맥관찰병이학결과.결과 여C조비교,V조저진식량화신경공능장애발생솔승고(P＜0.05);여V조비교,L조、M조화H조저진식량여신경공능장애발생솔강저,T_3시기저동맥직경증가,H조T_4시기저동맥직경증가(P＜0.05);여T_1시비교,V조T_(2,3)시기저동맥직경축단(P＜0.05),L조、M조화H조T_(2,3)시기저동맥직경차이무통계학의의(P＞0.05),T_4시기저동맥직경증가(P＜0.05);여L조화M조비교,H조T_4시기저동맥직경증가(P＜0.05).결론 이연정맥주사HTK(0.002 5～0.010 0 PNAU/kg,련속14 d)가개선토증상성뇌혈관경련,기효응정제량의뢰성.
Objective To investigate the effects of different doses of human tissue kallikrein(HTK)on symptomatic cerebral vasospasm in rabbits.Methods Forty Japanese white rabbits in which bilateral common carotid arteries were ligated without neurological deficits were randomly divided into 5 groups(n = 8 each): group A control;group B subarachnoid bemorrhage(SAH)and group C,D,E SAH+low,medium and high doses of HTK.Cerebral vasospasm(CVS)was induced by injecting non-anticoagulated autologous arterial blood 1 ml into cisterna magna twice at 48 h interval in group B,C,D,E.In group C,D,E HTK 0.002 5,0.005 0,and0.010 0 PNAU/kg in 5 ml normal saline were injected iv once a day for 14 consecutive days respectively starting after the first cisterna magna blood injection.In group A and B normal saline was injected instead of HTK.The food intake and neurological deficits were evaluated everyday.The diameter of basilar artery was detected by3D-CTA at 1 day before(T_1,baseline)and 5,7,14 d after cisterna magna blood injection(T_(2-4)).The basilar artery was removed for pathological examination at 15 clay after cisterna injection(T_5).Results The food intake was significantly decreased and the incidence of neurological deficits was increased in group B as compared with group A.Ⅳ HTK injection significantly attenuated the decrease in food intake and increase in neurological deficit incidence induced by SAH in group C,D,E as compared with group B.Vasospasm of basilar artery was observed at T_2 and T_3 in group B but not in other 4 groups.Conclusion Ⅳ HTK(0.002 5-0.010 0 PNAU/kg once a day for 14 consecutive days)can ameliorate symptomatic cerebral vasospasm in rabbits induced by SAH in a dose-dependent manner.