丹参酮ⅡA对脑缺血再灌注损伤大鼠磷酸化p38MAPK和MMP-9表达及细胞凋亡的影响

目的 探讨丹参酮ⅡA(Tanshinone,TanⅡA)对缺血再灌注(IR)损伤大鼠细胞凋亡和血脑屏障通透性的影响及与p38MAPK通路的关系.方法 60只大鼠随机分为假手术组(Sham组)、缺血再灌注组(IR组)、TanⅡA低剂量治疗组、TanⅡA高剂量治疗组,线栓法建立局灶性脑缺血再灌注模型.TanⅡA高、低剂量组于术前连续灌胃给予高、低剂量TanⅡA3d,每日1次.各组于脑缺血120min再灌注24h,采用免疫组化法观察大鼠额顶部皮质磷酸化p38 MAPK和MMP-9表达;TUNEL法检测神经细胞凋亡,检测伊文斯蓝(EB)含量变化.结果 (1)与Sham组相比,IR组磷酸化p38MAPK和MMP-9明显升高(P＜0.05);与IR组比较,TanⅡA高、低剂量治疗组磷酸化p38MAPK和MMP-9表达均降低,且高TanⅡA组明显低于低TanⅡA组(P均＜0.05);(2)与Sham组相比,IR组凋亡细胞明显增加;与IR组比较,TanⅡA高、低剂量治疗组凋亡细胞均减少,且高TanⅡA组明显低于低TanⅡA组(P均＜0.05).(3)与Sham组比较,IR组脑组织EB含量明显升高;与IR组比较,TanⅡA高、低剂量治疗组脑组织EB含量明显降低(P＜0.05),且高TanⅡA组明显低于低TanⅡA组(P均＜0.05).结论 TanⅡA减少脑缺血再灌注后细胞凋亡,抑制MMP-9表达降低血脑屏障通透性,可能与抑制p38 MAPK信号通路有关.     

丁苯酞对大鼠局灶性脑缺血再灌注后NF-κB与p38MAPK表达的影响

目的探讨丁苯酞(NBP)注射液对大鼠局灶性脑缺血再灌注(I/R)损伤后核转录因子-κB(NF-κB)与p38丝裂原活化蛋白激酶(p38MAPK)表达的影响。方法清洁级健康SD大鼠100只,根据随机分组法分成5组:假手术组(Sham组)、I/R组、NBP小剂量组(20mg·Lkg~(-1))、NBP中剂量组(40mg·Lkg~(-1))和NBP大剂量组(80mg·Lkg~(-1))各20只。采用Zea-longa线栓法制作大鼠局灶性IR模型,使用TTC染色法检测各组大鼠的脑梗死体积,苏木精-伊红染色法检测各组大鼠的脑梗死病理变化,利用Western blotting方法检测各组大鼠的NF-κB与p38MAPK表达以及NBP组大鼠经不同剂量NBP处理后的NF-κB与p38MAPK表达。结果 NBP组和IR组脑梗死体积明显高于Sham组,NBP组明显低于I/R组(P<0.05)。I/R组和Sham组相比,细胞排列紊乱,细胞数目减少,细胞间隙增宽,甚至严重的出现核固缩。I/R组和NBP组比Sham组中的p-NF-κB与p-p38MAPK表达升高(P<0.05)。结论 NBP能够抑制大鼠脑组织中磷酸化NF-B和磷酸化p38MAPK蛋白水平增加,减轻脑I/R损伤。     

基于p38丝裂原活化蛋白激酶通路的胰高血糖素样肽-1对大鼠脑缺血再灌注损伤的影响及机制

目的基于p38丝裂原活化蛋白激酶(p38MAPK)通路探讨胰高血糖素样肽-1(GLP-1)对大鼠脑缺血再灌注(I/R)损伤的影响及机制。方法将雄性SD大鼠分为假手术组、模型组、GLP-1组和p38MAPK抑制剂组,每组12只。模型组、GLP-1组和p38MAPK抑制剂组通过大脑中动脉栓塞及再灌注建立脑I/R损伤模型,GLP-1组给予利拉鲁肽(70μg/kg)、p38MAPK抑制剂组给予p38MAPK抑制剂SB202190(10μmol/L、5μl)干预。比较四组大鼠的脑梗死体积、水迷宫行为参数及梗死脑组织细胞凋亡率、氧化应激指标、炎症细胞因子、p38MAPK通路分子的差异。结果与模型组比较,GLP-1组和p38MAPK抑制剂组大鼠的脑梗死体积明显降低,逃避潜伏期明显缩短、穿越平台次数明显增多,梗死脑组织中的细胞凋亡率及丙二醛(MDA)、超氧化物歧化酶(SOD)、TNF-α、IL-1β、IL-6、p-p38水平显著减少,SOD、谷胱甘肽过氧化物酶(GPx)水平明显增加(均P<0.05),p-ERK1/2、p-JNK的表达水平无明显变化。与假手术组比较,模型组大鼠的逃避潜伏期明显延长、穿越平台次数明显减少,梗死脑组织的细胞凋亡率及MDA、ROS、TNF-α、IL-1β、IL-6、p-p38水平明显增高,SOD、GPx水平明显减少(均P<0.05),p-ERK1/2、p-JNK的表达水平无明显变化。结论GLP-1能够通过抑制p38介导的氧化应激及炎症反应减轻大鼠脑I/R损伤。     

全反式维甲酸对缺血再灌注大鼠血脑屏障通透性的影响

目的探究全反式维甲酸对缺血再灌注大鼠血脑屏障通透性的影响。方法将180只健康雄性大鼠完全随机分为假手术组(Sham),缺血再灌注组(I/R)和全反式维甲酸干预组(ATRA),每组60只,使用Zea Longa法制作局灶性脑缺血再灌注模型。在维甲酸干预(30 mg/kg)后不同时间点(1 d、3 d、7 d)分别通过测定大鼠脑梗死体积、伊文思蓝(EB)含量、基质金属蛋白酶-9(MMP-9)的表达来观察大鼠血脑屏障通透性的变化。结果缺血再灌注后脑梗死体积及EB含量均在1 d达高峰,之后逐渐下降,1 d及7 d时ATRA组脑梗死体积及EB含量均明显低于I/R组(P0.05)。MMP-9的表达3 d达高峰,免疫组化法显示3 d和7 d时ATRA组低于I/R组(P0.05),免疫印迹法显示1 d、3 d、7 d时ATRA组低于I/R组(P0.05)。结论全反式维甲酸可以减轻再灌注后血脑屏障的破坏。     

L-精氨酸通过抑制NF-кB途径减轻大鼠脑缺血-再灌注损伤

目的观察L-精氨酸(L-Arg)对大鼠脑缺血-再灌注(I/R)损伤的作用并探讨其机制。方法成年健康SD大鼠36只随机分3组,假手术(Sham)组、I/R组、L-Arg治疗(ARG)组,每组12只,采用大脑中动脉阻塞(MCAO)法建立大鼠局灶脑缺血模型。I/R组、ARG组于缺血2 h再灌注时分别给予生理盐水和L-Arg,实验中监测大鼠血压。于再灌注72 h后进行神经功能评分,TTC染色检测各组脑梗死体积百分比,Western blot测定大鼠缺血脑组织内NF-κB p65、IκBα的表达水平并进行组间比较。结果 1各组大鼠血压比较,差异无统计学意义(P>0.05);2与I/R组相比较,I/R后72 h,ARG组神经功能缺损程度评分明显改善(P<0.05),脑梗死体积显著缩小(P<0.05);3与Sham组比较,I/R组NF-κB p65表达明显升高(P<0.01),IκBα蛋白的表达明显降低(P<0.01);ARG组NF-κB p65的表达水平显著低于I/R组、高于Sham组(P<0.05),ARG组IκBα的表达水平显著高于I/R组、低于Sham组(P<0.05)。结论 I/R后早期给予L-Arg可减轻脑组织损伤,其机制与一氧化氮(NO)抑制NF-кB激活有关。     

p38MAPK在脑缺血后处理大鼠海马区的表达与意义

目的观察脑缺血后处理大鼠海马区神经元p38MAPK表达变化,探讨脑缺血后处理的脑保护机制。方法将96只雄性SD大鼠随机均分为假手术组(Sham组)、脑缺血组(IR组)、脑缺血后处理组(IpostC组)。Sham组只切开头部皮肤不电凝,分离颈总埋线不夹闭。IR组采用改良的Pulsinelli四血管闭塞(4-VO)法制作全脑缺血大鼠模型,缺血时间20min;IpostC组于IR组恢复再灌注前给予再灌注15s/缺血15s,重复3次处理。每组又按恢复再灌注后6h、24h、48h、72h分为4个亚组(每个亚组8只大鼠)。应用光镜观察各组大鼠海马区神经元形态变化;免疫组织化学染色和Western Blot检测海马区磷酸化p38MAPK表达情况。结果 IR组大鼠海马区神经元结构损伤严重,各时间点神经元坏死率增加,神经元磷酸化p38MAPK表达增多,差异有统计学意义(P0.05);与IR组比较,IpostC组大鼠海马区神经元结构损伤明显改善,各时间点神经元坏死率下降,神经元磷酸化p38MAPK表达明显增多,差异有统计学意义(P0.05)。结论脑缺血后处理对全脑缺血再灌注损伤具有保护作用,其机制可能与下调p38MAPK表达有关     

高渗氯化钠羟乙基淀粉40对大鼠脑缺血再灌注损伤后MMP-9和层粘连蛋白表达的影响

目的探讨高渗氯化钠羟乙基淀粉40(HSH)对大鼠脑缺血-再灌注(I/R)损伤后神经功能行为学评分,脑水肿情况,脑梗死体积以及脑组织中基质金属蛋白酶-9(MMP-9)和层粘连蛋白(Laminin)表达的影响。方法48只雄性SD大鼠随机分为假手术组、模型组、实验1组、实验2组。大鼠局灶性脑I/R损伤模型制备成功后120 min,假手术组和模型组静脉输注0.9%生理盐水,实验1组和2组分别静脉输注HSH 4 ml/kg和8 ml/kg。再灌注24 h后,行神经功能行为学评分,观察脑水肿情况,TTC染色测算脑梗死体积,用免疫印迹方法检测缺血区脑组织MMP-9和Laminin的表达。结果与假手术组比较,模型组神经功能行为学评分升高(P0.001);脑水肿加重;脑梗死体积增加(P0.001);MMP-9蛋白表达升高(P0.05);Laminin蛋白表达降低(P0.01)。与模型组比较,实验1组和2组神经功能行为学评分降低(P0.001);脑水肿缓解;脑梗死体积减少(P0.001);实验1组MMP-9蛋白表达减少(P0.01),Laminin蛋白表达升高(P0.05);实验2组MMP-9蛋白和Laminin蛋白表达均无明显变化。结论用HSH治疗大鼠脑I/R损伤后,大鼠神经功能行为学评分改善,脑水肿减轻,脑梗死体积减小,血脑屏障通透性降低,其机制可能与降低MMP-9和增加Laminin蛋白的表达有关。且保护作用以4 ml/kg剂量效果更佳。     

脑缺血预处理对沙鼠脑缺血再灌注损伤 p38MAPK活化的作用

目的 探讨脑缺血预处理对脑缺血后p38MAPK信号的影响.方法 蒙古沙鼠分成对照组、脑缺血再灌注组、脑缺血预处理组和抑制剂SB203580组.制备脑缺血及脑缺血预处理动物模型.免疫组织化学法和蛋白质印迹法检测海马区磷酸化p38MAPK的表达,TUNEL 法检测神经细胞凋亡,TTC染色测定脑梗死体积.结果 与对照组比较,脑缺血再灌注组磷酸化p38MAPK表达增高,凋亡神经细胞数量增加(P<0.05),磷酸化p38MAPK阳性细胞与TUNEL阳性细胞为同一神经元.与脑缺血再灌注组比较,脑缺血预处理组凋亡神经细胞下降、磷酸化p38MAPK表达较少、梗死面积缩小(P<0.05);抑制剂SB203580组磷酸化p38MAPK表达水平与脑缺血预处理组相似,但两组神经细胞凋亡数量及脑梗死体积比较,差异有统计学意义(P<0.05).结论 缺血预处理对脑缺血性损伤具有保护作用,其机制并非完全依赖p38MAPK信号活化.

Abstract：

Objective To study the effect of ischemic preconditioning on p38MAPK pathway after ischemia - reperfusion injury in gerbils. Method Gerbils were divided randomly into control group, ischemia - reperfusion group ( I/R ) , ischemia preconditioning group ( IP ) and inhibitor SB203580 group. Transient ischemia - reperfusion model and ischemia preconditioning model were performed. The expression levels of p38MAPK phosphorylation were detected by immunohistochemistry and Western blot, the neurons apoptosis were detected by TUNEL method and the infarction volume assessments were performed by TTC staining. Results Compared with control group, there were higher expression levels of p38MAPK phosphorylation,more apoptotic neurons in I/R group. The p38MAPK phosphorylation \positive cells and TUNEL positive cells were located in the same neurons. Compared with I/R group, there were lower expression levels of p38MAPK phosphorylation,fewer apoptotic neurons and smaller infarction volumes in IP group( P <0.05). The levels of p38MAPK phosphorylation in SB203580 group were similar as those in IP group( P > 0. 05 ) . However, the number of apoptotic neurons and infarction volumes were obviously changed ( P <0.05). Conclusions IP has protective effect from I/R damage in gerbils, which might be not only involved p38MAPK pathway.     

SB203580对液化石油气中毒大鼠神经元的保护作用

目的研究p38MAPK通路抑制剂SB203580在液化石油气中毒大鼠模型中对神经元的保护作用。方法采用大鼠液化石油气中毒模型,72只SD大鼠随机分为正常对照组、中毒组和SB203580干预组,干预组在中毒前1h腹腔注射SB203580(10mg/kg,溶于5mg/ml DMSO),动物分别于中毒后1d、3d、7d处死,观察脑组织神经元的形态变化,免疫组化方法检测脑组织p38MAPK的表达水平。结果中毒组大鼠脑组织神经元坏死,p-p38MAPK阳性细胞大量表达,干预组大鼠上述变化明显减轻(P<0.05)。结论在液化石油气中毒大鼠模型中,SB203580通过抑制p38MAPK通路减少神经元坏死,发挥神经保护作用。     

p38MAPK在体外培养星形胶质细胞缺氧/复氧损伤中的表达

目的 建立SD大鼠星形胶质细胞缺氧复氧损伤模型,探讨p38MAPK活性变化与星形胶质细胞损伤的关系.方法 体外培养新生SD大鼠星形胶质细胞,实验设正常对照组（N）、SB203580组（SB组,10 μmol/L）、缺氧/复氧组（H/R组）和缺氧/复氧组＋SB203580阻断p38MAPK组（H/R＋SB组）.应用MTT法、WB法、ELISA法检测缺氧4 h、8 h、复氧6 h、12 h、24 h、48 h时细胞存活率,p38MAPK、p-p38（磷酸化p38MAPK）及TNF-α的变化.结果 培养星形胶质细胞GFAP阳性表达率大于97%.缺氧/复氧使星形胶质细胞活力降低,SB203580阻断p38MAPK细胞活力高于H/R组,各组星形胶质细胞总p38MAPK水平无显著变化,缺氧复氧干预后p-p38表达上调,TNF-α水平显著增高.用SB203580阻断p38MAPK通路后,SB＋H/R组较H/R组p-p38、TNF-α水平降低.SB组总p38MAPK、p-p38、TNF-α水平与N组比较无显著变化.结论 p38MAPK信号通路参与了星形胶质细胞缺氧复氧损伤过程.     

Regional cerebral blood flow after occlusion of the middle cerebral artery

Occlusions of the middle cerebral artery (MCA) are mostly of embolic origin (appr. 80%) and give rise to about one third of all ischemic strokes, most of these being major strokes. MCA occlusions lasting for less than 1/2 h are tolerated without occurrence of permanent tissue damage. Occlusions lasting between 1/2 h to 4-8 h lead to permanent tissue damage and neurological deficits that are proportional to the duration of occlusion. Maximal tissue damage is obtained after 4-8 h occlusion. A cerebral blood flow of 8-23 ml/100 gr/min is sufficient for cellular viability but insufficient for normal tissue function ("ischemic penumbra"). Cellular function is completely abolished in the interval 8-16 ml/100 gr/min and flow at that level is tolerated only for 1-3 h before neuronal death ensues. In the interval 18-23 ml/100 gr/min there is some functional activity although it is reduced. Experimental and clinical evidence suggests that flow in this interval may be tolerated for several days, months or even longer ("chronic ischemic penumbra"). After MCA occlusion the blood flow falls below 8 ml/100 gr/min in most cases and permanent MCA occlusion always leads to relatively large areas of frank infarction. The ischemic infarcts may be surrounded by collaterally perfused areas where the blood flow is pressure-dependent (impaired autoregulation) and quite commonly insufficient for normal neuronal function (below 23 ml/100 gr/min). Such collaterally perfused areas may include a "chronic ischemic penumbra". Emboli causing MCA occlusions commonly disintegrate and/or migrate more peripherally within the first few weeks post stroke. This leads to reperfusion and changes of ischemic infarcts into hyperemic infarcts where flow is severely increased. The vascular reactivity is completely abolished in hyperemic infarcts and the hyperemic state lasts for about two weeks. Probably, anemic infarcts are equivalent to ischemic infarcts while the hemorrhagic variety is equivalent to hyperemic infarcts. The "partial infarct" with selective neuronal necrosis occurs in experimental animals after MCA occlusions of less than four h but not after permanent MCA occlusion. The significance of partial infarction in human stroke is not clarified. The extent of irreversible tissue damage can be reduced only if therapy sets in within 4-8 h after the occlusion. If a "chronic penumbra" exists the extension of reversible tissue damage can be reduced if therapy aimed at increasing the blood flow in the penumbra sets in within weeks or even months after the stroke.(ABSTRACT TRUNCATED AT 400 WORDS)     

Distribution of cerebral microembolism in the anterior and middle cerebral arteries

BACKGROUND AND PURPOSE: Cerebral infarcts occur more frequently along the middle (MCA) than the anterior cerebral artery (ACA) territory. The reason(s) for this difference remains speculative. The objective of this study was to investigate the distribution of cerebral microemboli as detected by transcranial Doppler ultrasound (TCD) along the MCA and ACA territories. METHODS: Records of consecutive patients examined for the presence of cerebral microembolism during a 32-month period at the Neurovascular Laboratory were reviewed. Of the original 375 TCD studies in 268 patients, 28 studies in 24 patients demonstrated microembolic signals (MES) and monitored the MCA and ACA on the same side. TCD studies were performed on TC-2000 or TC-2020 instruments. MES positive studies were saved and off-line reviewed. MES satisfied previously established criteria. RESULTS: MES were more frequent in the MCA than the ACA in 85.7% (24/28) of studies (P < 0.01). Of the total number of MES (n = 979), 29.6% (n = 290) were detected in the ACA and 70.4% (n=689) in the MCA (P<0.01). The mean (+/- SD) intensity of MCA MES of 12.2 (+/- 2.4) dB was significantly lower than that of ACA MES of 14.8 (+/-3.2) dB (P=0.05). The mean (+/-SD) duration of MCA MES of 38.1 (+/- 45.3) ms was longer than that of ACA MES of 30.7 (+/-34.0) ms (P=0.05). CONCLUSIONS: Cerebral microembolism occurs more frequently in the MCA than the ACA, which may explain the uneven distribution of cerebral infarcts along these arterial territories. Furthermore, there are significant differences in the characteristics of ACA and MCA MES.     

胰岛素抵抗与正常血压脑出血及脑梗塞关系的探讨

为研究胰岛素抵抗与脑出血、脑梗塞的关系,测定了正常血压脑出血41例、正常血压脑梗塞51例及对照组39例的血清胰岛素与血糖比值I/G,结果显示:三组I/G分别为6.3098±8.3268,5.1867±3.0069和2.4091±1.1374(means±SD)。正常血压脑出血组与对照组比较P<0.01。正常血压性脑梗塞组与对照组比较P<0.05。认为胰岛素抵抗是脑出血、脑梗塞的危险因素。     

急性脑梗死各临床亚型患者的脑血管反应性的变化

目的 探讨急性脑梗死各临床亚型患者脑血管反应性(CVR)的变化.方法 将70例急性脑梗死患者分为3个亚组:动脉硬化性血栓形成性脑梗死(AI)组(22例)、腔隙性脑梗死(LI)组(33例)和心源性脑梗死(CI)组(15例).应用经颅多普勒超声(TCD)检测各组患者双侧大脑中动脉(MCA)的平均流速(Vm)、脉动指数(PI)、阻力指数(RI)指标,通过屏气试验测定屏气指数(BHI);并与20名正常对照组进行比较. 结果与正常对照组相比,AI组Vm、PI、RI均显著升高(P<0.05～0.01),BHI明显降低(P<0.01);LI组Vm、BHI均显著降低(均P<0.05);而CI组各参数与正常对照组相比差异无统计学意义. 结论急性脑梗死各亚组的CVR改变并不相同,AI、LI组CVR损害更为明显,CVR检测对急性脑梗死各亚型的血液动力学研究有重要意义.     

无脑动脉狭窄急性脑梗死患者的临床特点

目的 探讨无脑动脉狭窄急性脑梗死(ACI)患者的临床特点.方法 对352例ACI患者进行数字减影全脑血管造影(DSA),根据检查结果分为无动脉狭窄组和动脉狭窄组,比较两组患者临床神经功能缺损评分、卒中危险因素和预后;并比较无动脉狭窄组中前循环梗死亚组与后循环梗死亚组的病情和预后.结果 根据DSA结果,无动脉狭窄组70例,动脉狭窄组282例.无动脉狭窄组患者合并高血压、糖尿病以及既往腩卒中、冠心病史者的比率明显低于动脉狭窄组(P<0.05～0.01);入院时及发病3个月时美国国立卫生研究院卒中鼍表(NIHSS)评分均明显低于动脉狭窄组,改良Rankin量表(mRS)评分及3个月卒中复发或死亡率明显低于动脉狭窄组(P<0.05～0.01);无动脉狭窄组中后循环梗死亚组患者入院时及发病3个月时NIHSS、mRS评分及死亡率明显高于前循环梗死亚组(P<0.05～0.01).结论 无明显脑动脉狭窄ACI患者的病情较轻,预后较好;但其中后循环梗死患者预后较差.     

Cerebral blood flow and cerebral hematocrit in patients with cerebral ischemia measured by single-photon emission computed tomography

Abstract– Single-photon emission computed tomography (SPECT) was used for the measurement of regional cerebral blood flow (CBF), cerebral blood volume (CBV) and cerebral hematocrit (Hct). CBF was measured using N-isopropyl-p-I-123-Iodoamphetamine. CBV was measured by both RBC tracer (Tc-99m RBC) and plasma tracer (Tc-99m human serum albumin) and cerebral hematocrit (Hct) was calculated. In normals, the cerebral-to-large vessel Hct ratio was 75.9%. Isovolemic hemodilution in patients with high Hct tended to increase the cerebral-to-large vessel Hct ratio. Low CBF, high CBV and slow cerebral blood mean transit time (MTT by dynamic CT scanning) was seen during the acute stage of completed infarction and during the symptom-free interval of TIA. Cerebral Hct was increased in the ischemic region of poor prognosis.     

血液光量子疗法对局灶性脑缺血大鼠大脑皮层局部血流量和脑水肿的影响

本文动态观测了光量子疗法治疗血栓栓塞性脑缺血大鼠,大脑皮层局部血流量(rCBF)及脑水肿的变化。结果:缺血6小时经光量子血液治疗2小时后,rCBF于注后30min明显增加,达19.78％(P<0.01),以后各点维持在一定水平,2小时增加到19.30(P<0.05)。脑组织比重:缺血中心区未见明显改善(P>0.1)而半暗区组织比重非常明显增加(P<0.001),可见水肿明显减轻。说明光量子疗法增加rCBF,减轻半暗区水肿。     

A cerebral cause of arthrogryposis: unilateral cerebral hypoplasia

The authors describe a case of predominantly right-sided arthrogryposis in an infant with contralateral congenital cerebral hypoplasia and associated unilateral hydrocephalus. Diagnosis was made by prenatal ultrasonography and confirmed by postnatal cerebral CT-scanning. In addition to a variety of congenital neuromuscular disorders, arthrogryposis may be caused by disorders of the central nervous system. Hence, in the diagnostic approach of newborns with congenital contractures, cerebral malformations must be considered.     

Statins and cerebral hemodynamics

HMG-CoA reductase inhibitors (statins) are associated with improved stroke outcome. This observation has been attributed in part to the palliative effect of statins on cerebral hemodynamics and cerebral autoregulation (CA), which are mediated mainly through the upregulation of endothelium nitric oxide synthase (eNOS). Several animal studies indicate that statin pretreatment enhances cerebral blood flow after ischemic stroke, although this finding is not further supported in clinical settings. Cerebral vasomotor reactivity, however, is significantly improved after long-term statin administration in most patients with severe small vessel disease, aneurysmal subarachnoid hemorrhage, or impaired baseline CA.     

重症脑梗死脑血流动力学的动态观察

目的:动态观察重症脑梗死脑血流动力学变化的特征和规律。方法:对42例急性重症脑梗死患者进行连续7天的TCD检测,20例正常人TCD检测数据作为正常组。结果:急性重症脑梗死患者脑血流速度减慢。血管阻力参数值(Pl、Rl)增大,病程的3～5天各指标变化达高峰。结论:根据脑血流动力学的特征性改变,表明重症脑梗死在病程早期就有不同程度的缺血性脑水肿发生,进展迅速,多在病程的3—5天达高峰:TCD用于床旁连续监测,可通过动态观察TCD参数变化,评价颅内压变化、判断预后。