目的探讨脑淋巴阻滞(CLB)对大鼠蛛网膜下腔出血(SAH)后脑血管痉挛(CVS)的影响及吡哆醇的干预作用。方法 60只Wistar大鼠随机分为正常对照组、SAH组、SAH+CLB组(CLB组)、SAH+CLB+吡哆醇组(吡哆醇组)、SAH+CLB+生理盐水组(生理盐水组)。采用自体动脉血枕大池二次注血法建立SAH模型;用结扎颈部淋巴管、摘除淋巴结制作CLB模型;吡哆醇组于制模前30 min及随后每12 h腹腔注射吡哆醇。第二次注血后48 h,在体观察各组大鼠基底动脉(BA)管径,检测BA对乙酰胆碱(Ach)的反应性,HE染色观察BA病理学变化。结果 (1)BA管径:SAH组明显小于正常对照组(P〈0.01);CLB组和生理盐水组明显小于SAH组(均P〈0.01);吡哆醇组较CLB组明显增大(P〈0.01)。(2)BA对Ach反应性:SAH组较正常对照组降低(P〈0.01);CLB组和生理盐水组较SAH组更低(均P〈0.01);吡哆醇组较CLB组明显改善(P〈0.01)。(3)BA病理学变化:正常对照组BA内膜光滑;SAH组血管内皮细胞肿胀,管腔狭窄,与正常对照组比较差异有统计学意义(P〈0.01);CLB组、生理盐水组管腔最窄,管壁最厚,大部分内皮细胞脱落(均P〈0.01);吡哆醇组血管损害较CLB组明显减轻(均P〈0.01)。结论 CLB可加重大鼠SAH后CVS及脑血管损害;吡哆醇可以减轻这些损害。
Objective To investigate the influence of cerebral lymphatic blockade(CLB) on cerebral vasospasm(CVS) after subarachnoid hemorrhage(SAH) and the interventional effect of Pyridoxine in rats.MethodsSixty Wistar rats were randomly divided into normal control group(NC group),SAH group,SAH+CLB group(CLB group),SAH+CLB+Pyridoxine group(Pyridoxine group),SAH+CLB+normal saline group(NS group).SAH model was established by double intracisternal injection of autologous arterial blood.CLB model was made by ligation of cervical lymphatics and extirpation of lymphonode.Pyridoxine was intraperitoneal injected in rats of Pyridoxine group 30 min before the model made and each 12 h follow up.After 48 h of the second blood injection,the vivo basilar artery(BA) diameter of rat in each group was observed.The BA reactivity on the acetylcholine(Ach) was measured.The BA histopathologic changes were observed by HE staining.Results(1) BA diameter: BA diameter in SAH group was significantly less than NC group(P0.01);which in CLB group and NS group were significantly less than SAH group(all P0.01);and in Pyridoxine group was significantly increased compared with CLB group(P0.01).(2) BA reactivity on Ach: The BA reactivity on Ach in SAH group was significantly decreased compared with NC group(P0.01);which in CLB group and NS group were significantly decreased than SAH group(all P0.01);but compared with CLB group,which in Pyridoxine group has remarkably improved(P0.01).(3) BA histopathologic change: In NC group,BA intima was smoot.In SAH group,the vascular endothelial cell was swelling,lumen was narrow,and significant difference than those in NC group(all P0.01).In CLB group and NS group,the lumens were the narrowest and the arterial wall were the thickest than SAH group(all P0.01);and the most of the endothelial cells of BA were detatchment;but those histopathologic changes in Pyridoxine group were significantly reduced than CLB group(all P0.01?