目的 探讨褪黑素对蛛网膜下腔(SAH)出血所致脑血管痉挛的影响.方法 将60只SD大鼠随机分为正常对照组、SAH组、溶剂组及褪黑素组,每组15只.采用视交叉上池自体血注射的方法制作大鼠SAH模型.褪黑素组于模型制备后立即经腹腔注射褪黑素一次(15 mg/kg),24 h再给同等量药物1次.溶剂组以10%无水乙醇(15 ml/kg)替代褪黑素,其他与褪黑素组相同.正常对照组不给予任何处理.于术后第2天行神经行为学评分检查;第3天行同步辐射血管造影(SRA)观察活体大鼠颅内血管管径变化情况,以及病理学检查(HE染色),观察大脑前动脉(ACA)直径.结果 ①褪黑素组神经行为学评分为(15.3±2.9)分,高于SAH组的(11.8±2.3)分和溶剂组的(11.6±3.4)分,均P＜0.05.但均低于正常对照组的18分,P＜0.05.②SRA法测量ACA直径,褪黑素组为(304±60)μm,与SAH组的(215±36)μm和溶剂组的(211±40)μm比较,差异有统计学意义,P＜0.05,但仍低于正常对照组的(349±26)μm,P＜0.05.③病理学检查测量ACA管径,褪黑素组为(185±34)μm,SAH组为(101±20)μm,溶剂组为(103±19)μm,差异有统计学意义,P＜0.05;均低于正常对照组的(216±10)μm,P＜0.05.结论褪黑素可明显改善SAH所致的脑血管痉挛.SRA法是一种能够直接评估活体大鼠SAH所致脑血管痉挛的新技术.%objective To investigate the effect of melatonin on sub arachnoid hemorrhage ( SAH ) -induced cerebral vasospasm. Methods Sixty SD rats were randomly allocated into a normal control group, a SAH group, a solvent group, and a melatonin group. A rat model of SAH was inducted by injecting autologous blood into prechiasmatic cistern. The melatonin was injected int rape rit one ally once ( 15 mg/ kg) in the rats of melatonin group immediately after modeling, and the same amount of drug was given a-gain at 24 hours. Melatonin was alternated by the equal volume of 10% ethanol ( 15 mL/kg ) in the solvent group, the others management were the same with the melatonin group. The normal control group did not give any treatment. Neurological score was assessed 2 days after surgery; synchrotron radiation angiography ( SRA ) and pathological examination ( HE staining ) were used to observe in vivo rat intracranial vascular changes and the diameter of anterior cerebral artery ( ACA ) at day 3. Results ①The neurobehavioral score in the melatonin group was 15. 3 ± 2. 9, it was higher than 11.8 ±2.3 in the SAH group and 11.6 ± 3.4 in the solvent group ( all P < 0. 05 ), however, they were all lower than 18 in the normal control group ( P < 0. 05 ). ②The ACA diameter was measured by SRA technique, the melatonin group was 304 ± 60μm. There was significant difference as compared to the 215 ±36 μm in the SAH group and 211 ±40 μm in the solvent group ( P < 0. 05 ), however, they still lower than 349 ± 26 μm in the normal control group ( P < 0. 05 ). ③ Pathology measurements of the AC A diameter in the melatonin group was 185 ±34 μm, in the SAH group was 101 ±20 μm, and in the solvent group was 103 ± 19 (xm. There were significant differences ( P<0.05 ); However they were all lower than 216 ± 10 μm in the normal control group ( P <0. 05 ). Conclusion Melatonin may significantly alleviate SAH-induced cerebral vasospasm. SRA is a novel technique that may directly evaluate the SAH-induced cerebral vasospasm of rats in vivo.
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