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目的探讨犬蛛网膜下腔出血(SAH)后脑血管痉挛(CVS)与内皮素(ET)和一氧化氮(NO)的关系、腰大池持续引流后两者变化及与经颅彩色多普勒超声(TCCD)相关性。方法采用犬SAH模型,测定SAH后腰大池持续引流前后不同时期,血浆和脑脊液中ET和NO含量,观察ET和NO动态变化,同时应用TCCD检查SAH模型不同时期脑动脉血流形态与流速。结果SAH后引流组血浆和脑脊液中ET含量增加和NO含量下降不明显(P＞0．05),非引流组血浆和脑脊液中ET含量增加和NO含量下降明显(P＜0．01)。TCCD显示：血浆和脑脊液中ET含量变化与大脑中动脉平均流速呈正相关,NO含量变化与大脑中动脉平均流速呈负相关。结论SAH后脑血管痉挛与ET含量增加和NO含量下降有关,腰大池持续引流有效清除引起脑血管痉挛因子ET,经颅彩色多普勒超声可以根据动脉血的流速和血流形态判断脑血管痉挛的程度及其预后。
Objective To investigate the relationship between cerebrovascular vasospasm (CVS) and endothelin (ET) and nitric oxide (NO) after subarachnoid hemorrhage (SAH) in dogs and their relationship with the changes of transcranial color Doppler ultrasonography (TCCD) correlation. Methods The contents of ET and NO in plasma and cerebrospinal fluid (CSF) were measured before and after continuous drainage in SAH model with canine SAH model. The dynamic changes of ET and NO were observed. At the same time, the morphology and flow rate of cerebral arterial blood flow in different periods of SAH model were examined by TCCD. Results After ETH, ET content and NO content in plasma and cerebrospinal fluid (CSF) were not significantly decreased (P> 0.05), but ET content and NO content in plasma and cerebrospinal fluid of non-drainage group decreased significantly (P <0.01). TCCD showed that ET content in plasma and cerebrospinal fluid was positively correlated with the average velocity of middle cerebral artery, and the change of NO was negatively correlated with the average velocity of middle cerebral artery. Conclusions Cerebral vasospasm after SAH is related to the increase of ET content and the decrease of NO content. Continuous drainage of the lumbar cistern effectively removes cerebral vasospasm factor ET and transcranial color Doppler ultrasound can be used to judge cerebral vasospasm according to the arterial blood flow velocity and blood flow pattern Degree and its prognosis.