Öz
Amaç:
Günümüzde, subraknoid kanama (SAK) sonrası ortaya çıkan vazospazm halen etkin olarak tedavi edilememektedir. β-1 reseptör antagonisti olan nebivololün, deneysel ve klinik araştırmalarda vazodilatasyon etkisi kanıtlanmıştır. Bu çalışmada, nebivololün SAK sonrası gelişen deneysel vazospazmın tedavisindeki etkinliği araştırılmıştır.
Yöntem:
Çalışmada, 32 adet Yeni Zelanda türü tavşan eşit olarak 4 gruba ayrıldı: 1) Kontrol grubu, 2) SAK grubu, 3) SAK + solvent verilen grup ve 4) SAK + nebivolol tedavi grubu. İkinci, 3. ve 4. gruptaki tavşanlarda tek kanamalı SAK modeli uygulandı. Tüm deneklere dijital anjiyografi yapıldı. Üçüncü ve 4. gruptaki tavşanlarda SAK sonrası 48. saatte transfemoral yöntemle Arteria vertebralis içine yerleştirilen kateterle 1 mL solvent (nebivololün içinde çözünmesinde kullanılan solüsyon) veya 1 mL hacim içinde 0.073 mg/kg dozda nebivolol infüzyonu yapıldı. SAH uygulanan 2., 3. ve 4. grup deneklere SAK uygulamasının 49. saatinde ve 1. gruptaki deneklere dijital anjiyografi yapıldı.
Bulgular:
Baziler arter ortalama çapları grup 1’de 0,64 mm, grup 2’de 0,33 mm, grup 3’te 0,37 mm ve grup 4’te 0,56 mm olarak saptandı. İkinci gruptaki deneklerde SAK sonrası 48. saatte yapılan dijital anjiyografi incelemesinde ağır vazospazm geliştirdiği saptandı. Baziler arter çapları dikkate alındığında, istatistiksel olarak grup 1 ve 4 sonuçları arasında anlamlı fark saptanmadı (p>0,05). Üçüncü grupta solvent verilen deneklerde ağır vazospazm oluşumu saptanmasına ragmen, dördüncü grupta nebivololün SAK’ye bağlı vazospazm gelişimini etkin olarak tedavi ettiği saptandı (p<0.01).
Sonuç:
Bu çalışmada elde edilen sonuçlar, β-1 reseptör antagonisti olan nebivololün SAK sonrası ortaya çıkan vazospazmın tedavisinde yeni bir seçenek olabilecegini ortaya koymuştur.
Anahtar Kelimeler: Nebivolol, subaraknoid kanama, tavşan, vazospazm
Kaynakça
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