Smeda J S, VanVliet B N, King S R
Division of Basic Medical Sciences, Memorial University of Newfoundland, St John's, Canada.
J Hypertens. 1999 Dec;17(12 Pt 1):1697-705. doi: 10.1097/00004872-199917120-00006.
We hypothesized that the loss of cerebral blood flow (CBF) auto-regulation under hypertensive conditions could promote cerebrovascular over-perfusion and haemorrhage formation. The possibility that CBF auto-regulation becomes defective prior to haemorrhagic stroke development was assessed in Wistar- Kyoto stroke-prone spontaneously hypertensive rats (SHRsp) and related to the myogenic responsiveness of the cerebrovasculature to pressure.
Laser Doppler techniques were used to measure relative CBF in relation to mean arterial pressure (MAP 130-260 mmHg) within the perfusion domains of the middle (MCA) and posterior (PCA) cerebral arteries. The ability of isolated MCAs and PCAs to constrict to a 120 mmHg pressure step (pressure-dependent constriction) was measured using a pressure myograph.
Two weeks prior to stroke, 10-week-old pre-stroke SHRsp exhibited near-constant CBF regulation to a 200 mmHg MAP. Thirteen-week-old pre-stroke SHRsp and age-matched post-stroke SHRsp lost their ability to auto-regulate CBF in the MCA and PCA perfusion domains. CBF increased at a high rate and in a linear manner with MAP. A distinct upper limit to CBF auto-regulation was absent. Pressure-dependent constriction was attenuated prior to stroke, and lost after stroke in isolated MCAs, but not the PCAs, of SHRsp.
The loss of CBF auto-regulation prior to stroke in SHRsp could enhance cerebral perfusion and facilitate the initiation of haemorrhage. Such dysfunction after stroke could produce secondary haemorrhages. Defects in pressure-dependent constriction cannot fully account for the pattern of CBF auto-regulation loss observed in post-stroke SHRsp.
我们假设高血压情况下脑血流量(CBF)自动调节功能的丧失会促进脑血管过度灌注和出血形成。在易发生中风的Wistar-Kyoto自发性高血压大鼠(SHRsp)中评估了出血性中风发生前CBF自动调节功能出现缺陷的可能性,并将其与脑血管对压力的肌源性反应性相关联。
使用激光多普勒技术测量大脑中动脉(MCA)和大脑后动脉(PCA)灌注区域内相对于平均动脉压(MAP 130 - 260 mmHg)的相对CBF。使用压力肌动描记仪测量分离的MCA和PCA对120 mmHg压力阶跃收缩的能力(压力依赖性收缩)。
在中风前两周,10周龄的中风前SHRsp对200 mmHg的MAP表现出近乎恒定的CBF调节。13周龄的中风前SHRsp和年龄匹配的中风后SHRsp在MCA和PCA灌注区域失去了自动调节CBF的能力。CBF随着MAP以高速率呈线性增加。CBF自动调节没有明显的上限。在SHRsp分离的MCA中,中风前压力依赖性收缩减弱,中风后丧失,但PCA未出现这种情况。
SHRsp中风前CBF自动调节功能的丧失可增强脑灌注并促进出血的起始。中风后的这种功能障碍可导致继发性出血。压力依赖性收缩的缺陷不能完全解释中风后SHRsp中观察到的CBF自动调节丧失模式。