梗塞性脳組織変化の薬剤による抑制—実験的研究，殊にmannitolとperfluorochemicalsの併用について

SUPPRESSION OF INFARCTIC CHANGES WITH MANNITOL AND FLUOROCHEMICALS : AN EXPERIMENTAL STUDY

I．はじめに

　臨床的に脳梗塞発症急性期にその急激な脳組織の変化を抑制する方法が判れば，内科的にも脳外科的にも有益な方法である。今まで，われわれはmannitolの抑制効果について種々発表してきた^{17,18,20,23）}。今回は，人工血液fluosolが酸素高運搬能を有し，また，粒子がきわめて小さいparticleであり，極小の血管にも進入し得るということに着目し，脳梗塞組織変化をより長時間抑制しうるのではないかと考え，すでに発表してきた薬剤判定に有利と考えられる脳腫脹モデル犬を使用して，mannitol単独，fluosol単独およびmannitol投与後fluosol投与によつて，それぞれの脳腫脹抑制効果を比較検討した。

We have developed and previously reported a canine model for diffuse, incomplete cerebral hemi-sphere infarction produced by simultaneously occluding the following 5 arteries unilaterally at the base of the brain: the A₂ portion of the anterior cerebral artery, the A₁ portion of theanterior cerebral artery at the bifurcation of the ethmoidal artery, the internal carotid artery, the posterior cerebral artery at the bifurcation of the posterior communicating artery and the anterior cerebellar artery. After 6 hours of occlusion, recirculation was allowed, and sequential observa-tion was made on the degree of brain swelling. Investigation was made on whether or not admi-nistration of 20% mannitol or fluorocarbon emulsi-on (20% fluosol DA) following vascular occlusion is effective in suppressing such swelling. It was found that brain swelling could be prevented using by mannitol and fluorocarbon emulsion together, but not mannitol and fluorocarbon emulsion alone.

Based on these results, we found that mannitol administered together with fluorocarbon emulsion has a protective effect for cerebral infarction follow-ing 6 hours vascular occlusion.