脳損傷急性期における脳循環・代謝についての実験的研究—特に細胞代謝関連物質の影響について

EXPERIMENTAL STUDY ON CEREBRAL CIRCULATION AND METABOLISM AT THE ACUTE BRAIN INJURY WITH SPECIAL EMPHASIS ON THE EFFECTS OF THE SUBSTANCES CONCERNING CEREBRAL METABOLISM

I．緒言

　近年交通および産業の発達に伴い頭部外傷患者は年々増加の傾向にあり，その治療の重要性がようやく認識されるようになつた。

　特に重症脳実質損傷については手術適応が少なく，主にsteroid療法，低体温療法などが行なわれているが，急性期死亡例の減少とともに悲惨な植物化状態例の増加，後遺症の問題など幾多の未解決な問題が残されている。

It is well known that cerebral circulation and meta-bolism are decreased in acute stage of brain in jury and cerebral tissue remains hypoxic. It may give a rise secondary to irriversible brain damage, if hypoxic condition of the cerebral tissue lasts for same period of time.

The primary purpose of this study is the medical aspect of brain injury, aiming to minimize the secon-dary damage of cerebral tissue due to following hyp-oxic brain condition.

I have examined the effects of the various substan-ces which concern with cerebral metabolism, upon cerebral circulation and metabolism. Shock damage was given on to brain of a dog through unopened dura mater, then substances concerning cerebral met-abolism were administratered such as A.T.P, Cyto-chrom C, G.A.B.A, and C.D.P.-cholin, and cerebral circulation and oxygen consumption were determined by N₂O mothod.

Data with these various substances were given in detail in article. Cytochrom C seems to give the most effective result in improving cerebral circulation and metabolism among them; C. B. F. incresaed to 163% compairing with control and C.M.R.O₂ also to 162%.

Then, the effect of daily administration of Cytochr-om C was studied on the 3rd and 7th day following experimental injury.

C.B.F. among control group decreased down to 64% of normal value in 1 hour after brain damage and to 71% on 3rd day and remained 85% on 7th day. With medication of Cytochrom C, C.B.F. was observed to be improving remarkably to 94% on 3rd day and to 113% on 7th day.

Among control group, C.M.R. O₂ decreased down 82% of the normal value in 1 hour and to 55% on 3rd day and remained 78% on 7th day following experimental brain injury.

After the administration of Cytochrom C, however C.M.R.O₂ was normalized to 105% on 3rd day and 104% on 7th day.

Circulatory and metabolic disturbances following brain injury were remarkably improved by daily administration of Cytochrom C. Such a effect of Cy-tochrom C seems to be usefull to correct clinical disturbances of acute brain injury.