悪性高血圧の患者における脳自律調節障害
Rogier V Immink1, Bert-Jan H van den Born, Gert A van Montfrans
1Department of Physiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Circulation
|October 7, 2004
まとめ
悪性高血圧の患者は,ナトリウムニトロプロシド (SNP) による急速な血圧低下中に動的および静的脳自己調節 (CA) の障害を示します. 中央脳動脈の血速度は,血圧の変化を密接に追随し,CAの損失を示しています.
科学分野:
- 神経学 神経学とは
- 心臓病学 心臓病学
- 高血圧の研究 高血圧の研究
背景:
- 悪性高血圧は,静脈内ナトリウムニトロプルシド (SNP) のような薬剤を用いた即時の親腸血圧低下を必要とします.
- 脳の自己調節 (CA) は,血圧の変動にもかかわらず,安定した脳血流を維持するために不可欠です.
研究 の 目的:
- 悪性高血圧患者のSNPによる急性血圧低下中に静的および動的脳自己調節 (CA) を評価する.
主な方法:
- 重度の高血圧と高血圧性網膜症の8人の患者の中脳動脈の血速度 (MCA V) と血圧のモニタリング.
- 0.1HzのMCA V (平均) からMAPのフェーズリードと,MCA V (平均) からMAPの静的CAを介してSNP輸液中に動的CAの関係を評価した.
- 8人の正常血圧の被験者と結果を比較した.
主要な成果:
- 患者は,対照群 (58+/-5度) と比較して,CA相のダイナミックリード (30+/-8度) が著しく低いことを示した.
- SNP治療中に,平均動脈圧 (MAP) は27%低下し,MCA V (平均) は22%低下した.
- MCA V (平均) プラトーは観察されず,急速な血圧低下の間に静的CAの損失を示唆しています.
結論:
- ダイナミック・セレブラル・オートレギュレーションは,悪性高血圧の患者で,急速な血圧低下を経験する患者で障害があります.
- 静的脳自己調節の喪失は,SNP治療中にMCA V (平均) プラトウの欠如によって示されました.
- MCA V (平均) で測定される脳血流は,これらの患者のSNP誘発性低血圧中の血圧変化をよく反映しています.
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