Staedt U, Hütt M, Herrmann B, Seufzer U, Leweling H
I. Med. Klinik am Klinikum Mannheim, Universität Heidelberg.
Infusionstherapie. 1989 Jun;16(3):107-12.
Hemorheological parameters, arterial blood gases and conjunctival oxygen tension were measured in 15 patients with acute ischemic stroke and compared with values obtained in an age matched reference group. Since the conjunctival capillary bed is perfused by the ophthalmic artery, it reflects the oxygen delivery to the areas supplied by the internal carotid artery. Measurements of conjunctival oxygen tension are simple and safe. Patients with acute ischemic stroke showed a lowered conjunctival oxygen tension; this holds true especially to the ipsilateral side, i.e. the side where the attack occurred, and to a lesser extent to the other side. By contrast, the ratio of arterial/conjunctival pO2 was disturbed only on the ipsilateral side. Furthermore, these patients had pathologically elevated values for red cell aggregation, whole blood and plasma viscosity. After infusing 500 ml 10% middle-molecular-weight hydroxyethyl starch (10% HAES-steril) and phlebotomy (250 ml) blood fluidity was normalized, although the hematokrit was only slightly reduced. Arterial pO2 improved slightly while pCO2 remained unchanged. Conjunctival oxygen tension improved by 30% on the ipsilateral and by 10% on the contralateral side, the ipsilateral values always remaining significantly lower. The ratio conjunctival/arterial pO2 raised only on the ipsilateral side where it was below the reference range before hemodilution. In addition to the well known improvement of blood fluidity and augmentation of cerebral blood flow following hemodilution in patients with acute ischemic stroke, there seems to be an increase in oxygen supply in the territories of both internal carotid arteries, especially on the ipsilateral side as indicated by the values of conjunctival oxygen tension and the ratio of conjunctival to arterial pO2.
对15例急性缺血性中风患者进行了血液流变学参数、动脉血气和结膜氧张力的测量，并与年龄匹配的参照组所获数值进行比较。由于结膜毛细血管床由眼动脉供血，它反映了向颈内动脉供血区域的氧输送情况。结膜氧张力的测量简单且安全。急性缺血性中风患者结膜氧张力降低；尤其在同侧（即发病侧）情况如此，对另一侧的影响较小。相比之下，动脉/结膜pO2比值仅在同侧出现紊乱。此外，这些患者的红细胞聚集、全血和血浆粘度值病理性升高。输注500ml 10%中分子量羟乙基淀粉（10%HAES-steril）并放血（250ml）后，血液流动性恢复正常，尽管血细胞比容仅略有降低。动脉pO2略有改善，而pCO2保持不变。同侧结膜氧张力提高了30%，对侧提高了10%，同侧的值始终显著较低。结膜/动脉pO2比值仅在同侧升高，且在血液稀释前低于参照范围。除了急性缺血性中风患者血液稀释后众所周知的血液流动性改善和脑血流量增加外，根据结膜氧张力值以及结膜与动脉pO2的比值来看，双侧颈内动脉供血区域的氧供应似乎有所增加，尤其是同侧。
