慢性期脳虚血症例の局所脳血流量に及ぼすグリセロールの効果

The Effect of Glycerol on Local Cerebral Blood Flow in Patients with Chronic Ischemic Cerebrovascular Lesions

　慢性期虚血性脳血管障害症例12例（男8例，女4例，平均56歳，小完成発作10例，一過性脳虚血発作2例）に，非放射性キセノンCT検査を行い，グリセロール投与による脳血流量増加を検討した。閉眼安静時に脳血流量（CBF）を測定し，次いでA群ではグリセロール200mlを，B群では電解質糖液200mlを20分間で点滴静注した後にCBFを測定した。その後アセタゾラミド1gを静注15分後にCBF測定を行い，脳血流予備能の残存することを確認した。A群（N＝7，14領域）ではCBF（ml／100g／min，以下ml）は安静時30.4±5.9ml，グリセロール投与後35.1±9.6ml（p＜0.01），アセタゾラミド投与後44.3±83mZであった。B群（N＝5，10領域）では，安静時29.9±6.3ml，電解質糖液投与後28.5±6.0ml，アセタゾラミド投与後45.0±9.0mlであった。グリセロールは慢性期脳虚血症例の局所脳血流量を有意に増加させる。

The effect of glycerol on local cerebral blood flow was examined in patients with chronic ischemic cerebrovascular diseases (CVD). Twelve patients with minor completed stroke (10 cases) or transient ischemic attacks (2 cases) were subjected to the study (8 males, 4 females, the age ranging 27 to 70 with average of 56 15 years).

Cerebral blood flow (CBF) was measured with stable xenon computerized tomography (Xe-CT). Each patient had 3 sequential Xe-CTs ; resting, with intravenous administration of 200 ml of glycer-ol (group A) or lactated Ringer's solution (group B) , and with intravenous administration of lg of acetazolamide.

The resting CBF, CBF with glycerol, and CBF with acetazolamide were 30.4±1.6ml/100 g/min (ml), 35.1±2.6ml, 44.2±2.2ml in group A, and 29.9± 2.0ml, 28.5 ±1.9ml, 45.0 ± 3.2ml in group B, respectively.

Glycerol increased CBF significantly in patients with chronic CVD, and seemed to be effective in ameliorating chronic low perfusion state in these patients.