흰쥐의 실험적 뇌지주막하 출혈에서 Nimodipine 투여 및 Urokinase 대조세척이 대뇌조직의 Leukotriene C₄ 함량에 미치는 영향

Abstract

To find out whether early lysis of subarachnoid blood clot with intracisternal urokinase as well as intraperitoneal nimodipine prevents or decreases the breakdown of arachidonic acid (AA) of the brain after subarachnoid hemorrhage(SAH), we have investigated the levels of leukotriene(LT1 C₄, the metabolite of the lipooxygenase pathway of the AA metabolism, in the brain tissue after experimental SAH in rats. The experimental S A H was induced by an intracistemal autologous blood injection through the catheter which was inserted into the cisterna magna Experimental animals were assigned to one of four groups as follows. The control group(Ⅰ) was that intracistemal saline irrigation was done after S A H induction. The second group(Ⅱ) was treated with an injection of nimodipine(4 times per a day of 1 2 m m until sacrificed) intrapentoneally after S A H induction, the third group(Ⅲ) was treated with an intracistemal umkinase imgation(3 times per a dayn of O.lml, lml 20,000 unit urokinase, until sacrificed) and the fourth group(IV) was treated with intraperitoneal nimodipine and intracistemal umkinase(same regimen as above). Average levels of LT Cq in each group was determined at 24 hours(subgroup a), 48 hours(subgroup b), 72 hours(subgroup c) after the induction of SAH by the radioimmunoassay method. The results showed that the average levels of LT C₄ was significantly enhanced in the brain tissue at 48 hours after SAH induction in control group(group Ⅰa vs. Ⅰb vs.Ⅰ Ic : 43.85± 15.62 vs. 18432k 27.46 vs. 3929+ 12.79pg/ml, respectivly. group Ia vs. Ib vs. Ic : p<O.Ol) and was decreased by intraperitoneal nimodipine, intracistemal urokinase or combination of both at 48 hours after SAH induction(group Ⅰb vs. Ⅱb vs. Ⅲb vs. Ⅳb 184.32k27.46 vs. 41.99f5.94 vs. 37.68k 10.4 vs. 37.38k 9.27pg/ml, respectively p u p Ⅰb vs. Ⅱb, Ⅲb, and Ⅳb : p<0.05). However, there was no significant differences among the second, the third and the fourth group(group 1Ta vs. Ⅲa vs. Ⅳa, group Ⅱb vs. Ⅲb vs. Ⅳb and group Ⅱc vs. Ⅲc vs. Ⅳc : 41.07±7.06 vs. 37.97± 4.48 vs. 31.84± 6.07pglml, 41.99± 5.94 vs. 37.68± 10.43 vs. 37.38± 9.27pg/ml and 36.41± 6.76 vs. 37.98± 3.45 VS. 35.59k 837pghl. respectively). We concluded that the early lysis of subarachnoid blood clot with intracistemal urokinase had some benefits against the damage of neurons in the early period after SAH as much as intraperitoneal injection of nimodipine. However, the benefit of the combined treatment with intraperitoneal nimodipine and intracisternal urokinase, compared to intraperitoneal nimodipine or intracisternal urokinase alone, has not been clearly established.