The topography of impaired micro vascular perfusion in the primate brain following total circulatory arrest
The topography of impaired micro vascular perfusion in the primate brain following total circulatory arrest
复制标题
全循环停止后灵长类大脑微血管灌注受损的地形
作者：
M. Ginsberg;R. Myers
各种中枢神经系统（CNS）结构对缺氧或缺血的不同脆弱性的潜在因素长期以来一直刺激着研究和推测。最近，人们的注意力集中在脑微血管系统因缺血性损伤而产生的改变上^，^-7，并且有人认为这些改变在某些情况下可能是选择性CNS实质损伤的原因。艾姆斯和牛ork使用家兔进行全脑缺血，随后用胶体碳悬浮液灌注，证明了在短暂的七分钟半到十分钟的缺血后，大脑中出现了小的灌注缺陷。缺血仅持续15分钟后，就出现了广泛的、汇合的非灌注区，占总脑体积的一半以上。Cantu和Ames 6指出，脑干、小脑、基底神经节和间脑内的再循环通常在缺血仅7.5分钟后就显著受损，在缺血15分钟后则广泛受损。相反，米勒和迈尔斯在研究幼年恒河猴时观察到，全身循环停止持续长达20分钟，在少数情况下，动物存活时间延长，神经系统状态几乎保持正常。很明显的脑部病变，
The factors underlying the differential vulnerabilities of various central nervous system (CNS) structures to hypoxia or ischemia have long stimulated investigation and speculation.’ 3’ Recently, attention has been directed to alterations produced in the cerebral microvasculature by prior ischemic insult^,^ -7 and it has been suggested that these changes might account, in some instances, for selective CNS parenchymal damage.3 t4 3 6 Ames and cow o r k e r ~ , ~ using rabbits subjected to episodes of total cerebral ischemia and subsequently perfused wi th colloidal carbon suspensions, demonstrated the development of small perfusion defects in the brain following as brief a period as seven and one-half t o ten minutes of ischemia. Extensive, confluent areas of nonperfusion involving over one-half of the total brain bulk appeared after episodes of ischemia lasting only fifteen minutes. Cantu and Ames6 noted that recirculation within the brainstem, cerebellum, basal ganglia, and diencephalon was often significantly impaired after only seven and one-half minutes and extensively so after fifteen minutes of ischemia. In contrast, Miller and Myers,’ working with juvenile rhesus monkeys, observed that total systemic circulatory arrest lasting as long as twenty minutes was compatible with prolonged animal survival with preservation of a nearly normal neurological status in a few instances. Mi cr 0s co pically apparent brain pathology,