在患有恶性高血压的患者中,大脑自身调节受损
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
概括
恶性高血压患者在用酸 (SNP) 快速降低血压期间显示出动态和静态大脑自调节 (CA) 功能受损. 中脑动脉的血液速度紧密跟随血压变化,表明CA的损失.
科学领域:
- 神经学 神经学
- 心脏病学 心脏病学
- 高血压研究 高血压研究
背景情况:
- 恶性高血压需要使用诸如静脉注射酸 (SNP) 等药物立即降低肠外血压.
- 大脑自调节 (CA) 对于维持稳定的大脑血流至关重要,尽管血压波动.
研究的目的:
- 在患有恶性高血压的患者中,在SNP急性降血压期间评估静态和动态大脑自身调节 (CA).
主要方法:
- 在8名患有严重高血压和高血压视网膜病变的患者中监测中脑动脉血速 (MCA V) 和血压.
- 在SNP输注期间,使用0.1Hz的MCA V (平均值) 来评估动态CA与MAP相位的关系,并通过MCA V (平均值) 来评估静态CA与MAP的关系.
- 与8名血压正常的受试者进行了比较.
主要成果:
- 与对照组 (58+/-5度) 相比,患者表现出明显较低的动态CA阶段领先率 (30+/-8度).
- 在SNP治疗期间,平均动脉压 (MAP) 降低了27%,MCA V (平均) 线性降低了22%.
- 没有观察到MCA V (平均值) 平原,这表明在快速降低血压时会失去静态CA.
结论:
- 恶性高血压患者经历快速降低血压的动态大脑自身调节受损.
- 在SNP治疗期间,MCA V (平均值) 平原的缺失表明静态大脑自调节的丧失.
- 通过MCA V (平均值) 测量的大脑血流量,与这些患者在SNP诱导的低血压期间的血压变化非常相似.
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