《中国康复理论与实践》

《中国康复理论与实践》 ›› 2004, Vol. 10 ›› Issue (08): 461-463.

• 基础研究 • 上一篇    下一篇

蛛网膜下腔出血后脑自我调节机制的持续评价

刘丽萍; 王春雪; 赵性泉; 王桂红; 王拥军   

  1. 1.首都医科大学附属北京天坛医院神经内科 北京市 100050
  • 收稿日期:2004-05-17 出版日期:2004-08-25 发布日期:2004-08-25

Continuous assessment of cerebral autoregulation in subarachnoid hemorrhage

LIU Li-ping, WANG Chun-xue, ZHAO Xing-quan, et al   

  1. Department of Neurology, Tiantan Hospital, Beijing 100050, China
  • Received:2004-05-17 Published:2004-08-25 Online:2004-08-25

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被引次数

7

摘要： 目的评价蛛网膜下腔出血(SAH)后血管痉挛对脑自我调节状态的影响。方法动脉血压与平均血流速度(FV)及收缩期FV之间的相关系数分别称为“Mx”、“Sx”,当FV>120cm/s及Lindegaard率>3时定义为血管痉挛。32例SAH患者中,15例出现血管痉挛。对伴有血管痉挛的患者双侧大脑中动脉行经颅彩色多普勒(TCD)检测,比较Mx和Sx基础值和痉挛期的变化。结果痉挛期Mx(0.46±0.32)较基础值(0.21±0.24)升高(P=0.03)。Sx值分别为(0.22±0.26)、(0.05±0.21),痉挛期增高(P=0.03)。Mx与FV(r=0.577,P=0.006)、Lindegaard率(r=0.672,P<0.01)相关。与对侧相比,痉挛侧的Mx、Sx增高(P分别为0.006,0.044)。结论痉挛期Mx、Sx增高提示脑血管的自我调节机制受损,对蛛网膜下腔出血患者的自我调节状态的改变提供了另外的评价方法。

关键词: 脑血流, 自我调节, 蛛网膜下腔出血(SAH)

Abstract: ObjectiveTo examined how autoregulation is affected by vasospasm after subarachnoid hemorrhage (SAH) by using transcranial Doppler. MethodsThe moving correlation coefficient between slow changes of arterial blood pressure and mean or systolic flow velocity (FV), termed Mx and Sx, respectively, was used to characterize cerebral autoregulation. Vasospasm was declared when the mean FV increased to more than 120 cm/s and the Lindegaard ratio was more than 3. This occurred in 15 of 32 SAH patients.On the basis of the bilateral transcranial Doppler recordings of the middle cerebral artery in vasospastic patients, Mx and Sx were calculated for baseline and vasospasm. ResultsMx increased during vasospasm (0.46±0.32) and was significantly higher (P=0.03) than at baseline (0.21±0.24) Sx was also increased (0.22±0.26 vs 0.05±0.21,P=0.03). Mx correlated with mean FV (P=0.577, P=0.006) and the Lindegaard ratio (r=0.672,P<0.01).Mx(P=0.006) and Sx (P=0.044) were higher on the vasospastic side compared with the contralateral side.ConclusionThe increased Mx and Sx during cerebral vasospasm demonstrate impaired cerebral autoregulation. Mx and Sx provide additional information on changes in autoregulation in SAH patients.

Key words: cerebral blood flow, autoregulation, subarachnoid hemorrhage (SAH)