脑卒中后大脑中动脉功能:肌源性活动的再灌注阈值持续时间

M. Cipolla, A. Curry
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引用次数: 87

摘要

背景和目的-脑动脉的肌生成活动是脑血流自动调节的重要因素。先前的研究表明,缺血时间的增加减少了脑动脉中肌原性张力的数量。在本研究中,我们研究了脑缺血再灌注不同时期对大脑中动脉(MCAs)肌生成行为的影响。我们测量了75毫米汞柱时自发性肌张力的数量,以及对跨壁压力(TMP)增加的收缩反应,即肌源性反应性。方法:采用雄性Wistar大鼠(n=45)的MCA闭塞模型,诱导30分钟暂时性缺血,然后进行不同时期的再灌注(0或假手术;30分钟;以及6、12、18、20和22小时),由激光多普勒血流仪证实。使用动脉造影系统在体外研究MCAs,该系统允许控制TMP和测量管腔直径。在75毫米汞柱下平衡1小时后,TMP以25毫米汞柱的增量逐步增加到125毫米汞柱,并在每种压力下测量管腔直径。测定缺血和对侧动脉各再灌注期自发性肌张力的量,并与假手术组左、右MCAs进行比较。然后在动脉造影液中用10%福尔马林加压固定动脉,并用荧光标记的phalloidin(一种特异性的F-actin探针)对丝状(F)肌动蛋白进行染色。用共聚焦显微镜定量f -肌动蛋白的量。结果:假手术对照组的mca具有相当大的肌原性张力(35%)。然而,随着再灌注时间的延长,缺血mca的张力量逐渐减少。此外,假手术对照动脉对TMP的增加有肌源性反应,直径随着压力的增加而减小。再灌注30分钟和6小时的动脉也有类似的反应,压力-直径曲线均呈负斜率;然而,肌原性反应性在较长时间的再灌注后减弱,使图呈现正斜率。压力-直径曲线斜率分别为:−0.10±−0.06(假手术)、−0.07±−0.12(30分钟)、−0.08±−0.11(6小时)、+0.09±0.09(12小时)、+0.25±0.16(18小时)、+0.38±0.09(20小时)、+0.57±0.09(22小时)。再灌注6小时和12小时时,f -肌动蛋白含量仅在缺血mca中显著降低。结论-这些结果表明,较长的再灌注时间显著降低mca的肌生成活性。了解不同时期的缺血再灌注对脑循环功能的影响,有助于更有效地治疗缺血性脑卒中。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Middle Cerebral Artery Function After Stroke: The Threshold Duration of Reperfusion for Myogenic Activity
Background and Purpose— Myogenic activity of the cerebral arteries is an important contributor to autoregulation of cerebral blood flow. Previous studies have demonstrated that increasing periods of ischemia diminished the amount of myogenic tone in cerebral arteries. In the present study, we investigated the effect of different periods of postischemic reperfusion on the myogenic behavior of middle cerebral arteries (MCAs). We measured both the amount of spontaneous myogenic tone that developed at 75 mm Hg and the contractile response to increased transmural pressure (TMP), ie, myogenic reactivity. Methods— The MCA occlusion model was used in male Wistar rats (n=45) to induce 30 minutes of temporary ischemia, followed by different periods of reperfusion (0 or sham; 30 minutes; and 6, 12, 18, 20, and 22 hours), confirmed by laser Doppler flowmetry. MCAs were studied in vitro using an arteriograph system that allowed control of TMP and measurement of lumen diameter. After equilibration for 1 hour at 75 mm Hg, TMP was increased stepwise in 25–mm Hg increments to 125 mm Hg and lumen diameter measured at each pressure. The amount of spontaneous myogenic tone was determined in both ischemic and contralateral arteries for each reperfusion period and compared with the right and left MCAs in the sham group. Arteries were then fixed with 10% formalin pressurized in the arteriograph bath and stained for filamentous (F)–actin with fluorescently labeled phalloidin, a specific probe for F-actin. The amount of F-actin was quantified using confocal microscopy. Results— MCAs from the sham-operated control group possessed considerable myogenic tone (35%). However, the amount of tone in ischemic MCAs progressively diminished as the reperfusion duration increased. In addition, sham-operated control arteries responded myogenically to increases in TMP, decreasing diameter as pressure increased. There was a similar response in arteries exposed to 30 minutes and 6 hours of reperfusion, all producing a negative slope on the pressure-diameter curve; however, myogenic reactivity was diminished at the longer periods of reperfusion, producing a positive slope of the graph. The slopes of the pressure-diameter curves were as follows: −0.10±−0.06 (sham), −0.07±−0.12 (30 minutes), −0.08±−0.11 (6 hours), +0.09±0.09 (12 hours), +0.25±0.16 (18 hours), +0.38±0.09 (20 hours), and +0.57±0.09 (22 hours). F-actin content was significantly less only in ischemic MCAs at 6 and 12 hours of reperfusion. Conclusions— These results demonstrate that longer periods of reperfusion significantly diminish myogenic activity of MCAs. Understanding how different periods of ischemia and reperfusion affect the function of the cerebral circulation may promote more effective treatment of ischemic stroke.
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