目的探讨脑内物质经淋巴引流途径在蛛网膜下腔出血(SAH)后继发性脑缺血的作用。方法将Wistar大鼠随机分入正常对照组、SAH组、SAH+脑淋巴引流阻滞(CLB)组。用结扎颈部淋巴管并摘除淋巴的方法制作CLB模型,用枕大池两次注血法制作SAH模型;在SAH+CLB组,先制作CLB模型,1 d后制作SAH模型。在术后12 h内检测脑灌注压;于术后3 d观察基底动脉对乙酰胆碱的反应性。结果SAH组于枕大池注入动脉血后脑灌注压显著而持续下降,SAH+CLB组脑灌注压下降更加显著。表面滴加乙酰胆碱后,SAH组基底动脉舒张百分率显著小于正常对照组,SAH+CLB组基底动脉舒张百分率显著小于SAH组。结论脑淋巴引流途径阻滞可降低SAH后脑灌注压和基底动脉对乙酰胆碱的反应性,提示该途径在SAH后继发性脑缺血损伤中可能发挥内源性保护作用。
Objective:To investigate the possible role of cerebral lymphatic drainage pathway in the process of secondary cerebral ischemic injury following subarachnoid hemorrhage(SAH).Methods: Wistar rats were divided into normal control,SAH,and SAH+CLB groups.Cerebral lymphatic blockage(CLB) models were produced by removal of cervical lymphatic nodes after obstruction of the tubes,and SAH models were produced using a double cisternal injection of autologus arterial blood.In SAH+CLB group,SAH was induced 1d after pro...