下体正负压条件及头高脚低和头低脚高倾斜时的颅静脉流出情况。

Cranial venous outflow under lower body positive and negative pressure conditions and head-up and -down tilts.

作者信息

Stolz Erwin, Fox Bettina C, Hoffmann Oskar, Gerriets Tibo, Blaes Franz, Kraus Jörg, Kaps Manfred

机构信息

Department of Neurology, Justus-Liebig-University, Giessen, Germany.

出版信息

J Neuroimaging. 2009 Jan;19(1):31-6. doi: 10.1111/j.1552-6569.2008.00250.x. Epub 2008 Sep 16.

DOI:10.1111/j.1552-6569.2008.00250.x

PMID:18798778

Abstract

BACKGROUND

Although there exists a large body of knowledge on the regulation of arterial cerebral hemodynamics, little is known about the cerebral venous outflow (CVO).

METHODS

In 19 healthy volunteers, the middle cerebral artery and the straight sinus were examined using transcranial Doppler sonography. Arterial and venous mean flow velocities (aFV(mean), vFV(mean), respectively) were registered continuously while applying lower body positive (LBPP) or negative (LBNP) pressure of 30 mmHg and performing head-down (-20 degrees , HDT) and -up (+30 degrees , HUT) tilt manoeuvres. The arterial blood pressure was registered simultaneously with a noninvasive finger blood pressure monitor. Relative changes in parameters compared to the proceeding no-pressure, no-tilt baseline were used for analysis.

RESULTS

While aFV(mean) did not change significantly, vFV(mean) inc reased during LBPP by 10.5 +/- 2.9% and decreased during LBNP by 15.1 +/- 3.5% (mean +/- standard error of mean [SEM], P < .01). HUT resulted in a decrease in vFV(mean) by 25.5 +/- 3.3% and HDT, in an increase by 7.8 +/- 3.2% (P < .01) without alteration in aFV(mean). This may imply a decrease of cerebral blood volume (CBV) during LBPP and HDT and an increase during LBNP and HUT.

CONCLUSIONS

CVO cannot be neglected when studying cerebral hemodynamics because it might affect the CBV.

摘要

背景

尽管关于动脉性脑血流动力学调节已有大量知识，但对脑静脉流出道（CVO）却知之甚少。

方法

对19名健康志愿者使用经颅多普勒超声检查大脑中动脉和直窦。在施加30 mmHg的下体正压（LBPP）或负压（LBNP）并进行头低位（-20度，HDT）和头高位（+30度，HUT）倾斜操作时，连续记录动脉和静脉平均流速（分别为aFV(mean)、vFV(mean)）。同时使用无创手指血压监测仪记录动脉血压。与之前无压力、无倾斜的基线相比，参数的相对变化用于分析。

结果

虽然aFV(mean)无显著变化，但vFV(mean)在LBPP期间增加了10.5±2.9%，在LBNP期间降低了15.1±3.5%（平均值±平均标准误差[SEM]，P<.01）。HUT导致vFV(mean)降低25.5±3.3%，HDT则使其增加7.8±3.2%（P<.01），而aFV(mean)无改变。这可能意味着在LBPP和HDT期间脑血容量（CBV）减少，而在LBNP和HUT期间增加。