The effects of dihydroergotamine in patients with head injury and raised intracranial pressure
The effects of dihydroergotamine in patients with head injury and raised intracranial pressure
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双氢麦角胺对颅脑损伤合并颅内压升高患者的影响
DOI：
10.1007/bf00273564
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发表时间：
2004
影响因子：
38.9
通讯作者：
P. Grände
中科院分区：
文献类型：
--
作者：
P. Grände
在第一项研究中，6例颅脑损伤后脑水肿颅内压升高的患者由于低灌注压给予二氢麦角胺。颅内压随动脉压升高而下降。单次静脉注射0.25 mg双氢麦角胺后，颅内压从24±2 mmHg下降了最大12±1 mmHg，并在35-70分钟内保持在低水平，然后稳定在比基线低5±1 mmHg的新水平。颅内压最初迅速而显著的下降可能是颅内血容量减少的结果，主要是由于更大容量的静脉电容血管收缩（类比于二氢麦角胺对骨骼肌和皮肤的相应血管作用）。在第二项研究中，使用交感神经切除的猫骨骼肌进行的实验表明，二氢麦角胺还可以降低静水毛细血管压力，诱导液体从间质组织吸收到血液中。这表明，在受损的大脑中，类似的经毛细血管吸收效应可能是观察到的颅内压稳定在低于初始水平的二氢麦角胺后的解释。
In the first study 6 patients with raised intracranial pressure due to brain oedema following head injury were given dihydroergotamine because of low perfusion pressure. The intracranial pressure fell simultaneously with the increase in arterial pressure. The intracranial pressure fell from 24±2 mmHg by a maximum of 12±1 mmHg after a single intravenous injection of 0.25 mg of dihydroergotamine and remained at a low level for 35–70 min before stabilizing at a new level 5±1 mmHg below the baseline. The initial rapid and marked decrease in intracranial pressure may be the result of a reduced intracranial blood volume, due predominantly to constriction of the more voluminous venous capacitance vessels (by analogy with the corresponding vascular effect of dihydroergotamine on skeletal muscle and skin.) In the second study, experiments using sympathectomized cat skeletal muscle, showed that dihydroergotamine also reduced the hydrostatic capillary pressure, inducing absorption of fluid from the interstitial tissue to blood. It is suggested that a similar transcapillary absorption effect in the damaged brain may be an explanation for the observation that the intracranial pressure stabilized at a level below the initial one following dihydroergotamine.