Diehl Rolf R
Department of Neurology, Krupp Hospital, Alfried-Krupp-Str 21, 45117, Essen, Germany.
Eur J Ultrasound. 2002 Nov;16(1-2):31-6. doi: 10.1016/s0929-8266(02)00048-4.
During the past 15 years several paradigms to study dynamic cerebral autoregulation (CA) were developed by measuring cerebral blood flow (CBF) velocity with transcranial Doppler (TCD) in response to blood pressure changes. As a more indirect approach to measure autoregulation, vasomotor reactivity (VMR) can be determined by the use of vasodilatory stimuli. CA or VMR are often severely disturbed in occlusive carotid artery disease. Several prospective studies have shown that reduced VMR is an important risk factor for stroke or TIA in patients with symptomatic and asymptomatic carotid artery stenosis or occlusion. Future randomized intervention studies will show whether asymptomatic patients with carotid artery stenosis and pathological autoregulation or VMR will benefit from revascularization therapy.
在过去15年中，通过经颅多普勒（TCD）测量脑血流（CBF）速度以响应血压变化，开发了几种研究动态脑自动调节（CA）的范例。作为一种更间接的测量自动调节的方法，血管运动反应性（VMR）可以通过使用血管舒张刺激来确定。CA或VMR在闭塞性颈动脉疾病中常常受到严重干扰。几项前瞻性研究表明，VMR降低是有症状和无症状颈动脉狭窄或闭塞患者发生中风或短暂性脑缺血发作（TIA）的重要危险因素。未来的随机干预研究将表明，患有颈动脉狭窄且存在病理性自动调节或VMR的无症状患者是否将从血运重建治疗中获益。
