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在大血管封闭性中风内血管治疗期间,双边动态大脑自身调节评估

Adam Vittrup Heiberg^1,2, Troels Gil Lukassen¹, Thomas Clement Truelsen^1,2

¹Department of Neurology, Copenhagen University Hospital - Rigshospitalet, Glostrup, Denmark.

Experimental physiology

|November 20, 2025

概括

在中风内血管治疗 (EVT) 期间,动态大脑自身调节 (dCA) 监测显示了半球二氧化碳敏感性的差异,并预测了患者的结果. 个性化血压管理可能会改善结果.

科学领域:

神经科学是一个神经科学.
神经学神经学
医疗技术医疗技术医学技术

背景情况:

内血管治疗 (EVT) 在急性缺血性中风中有效地重新利用大血管封闭.
动态大脑自调节 (dCA) 对于维持大脑血液流动至关重要,但据报道,在EVT后受损.
基于dCA的个性化血压管理可能会改善患者在EVT后的结果.

研究的目的:

调查使用近红外光谱学 (NIRS) 来评估EVT期间dCA的可行性.
在EVT期间评估半球之间的dCA差异.
探索dCA与EVT后90天功能结果之间的关系.

主要方法:

在EVT之前,期间和之后持续测量NIRS和动脉血压 (ABP).
对NIRS和ABP的转移函数分析来计算dCA相位移 (0.07-0.2Hz).
在缺血半球和逆侧半球之间对dCA相位移的比较以及对CO2敏感性的评估.

主要成果:

半球之间的相位转移没有显著差异,但在 ischemic 半球后重新调节后,二氧化碳敏感性增加.
随着时间的推移,相位转移与90天的功能结果相互作用:相位转移的增加与良好结果相关,而相位转移的减少表明结果不佳.
在具有良好的和差的功能结果的患者中,dCA的演变不同.

结论:

NIRS是一种可行的方法,用于在EVT期间评估dCA.
在dCA的二氧化碳敏感性中存在半球差异.
在EVT期间进行个性化dCA监测表明,量身定制的血压管理有可能改善中风的结果.

关键词:

急性缺血性中风急性缺血性中风大脑循环大脑循环动态的大脑自我调节血管内治疗血管内治疗大型血管封闭症近红外光谱学近红外光谱学进行血栓切除术 (thrombectomy).转移函数分析转移函数分析

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