Krdžić Ivana, Čovičković-Šternić Nadežda, Katsiki Niki, Isenović Esma R, Radak Đorđe
Special Hospital for Cerebrovascular Diseases, "Sveti Sava," Belgrade, Serbia
Institute for Neurology, Clinical Hospital Center, Belgrade University of Medicine, Belgrade, Serbia.
Angiology. 2015 May;66(5):481-7. doi: 10.1177/0003319714538312. Epub 2014 Jun 5.
We assessed reactivity of cerebral vessels on hypercapnia in patients with carotid occlusive disease. The effects of vascular risk factors on carotid atherosclerosis and vasomotor reactivity (VMR) of cerebral arterioles were also examined. Patients (n = 50) with carotid stenosis (≥30% in 1 or both sides) were included; 30 patients acted as controls. Hypertension, hyperlipidemia, diabetes, cardiac diseases, inflammation, and smoking were recorded. Vasomotor reactivity was assessed with the apnea test by transcranial Doppler ultrasonography and estimated by flow velocity changes in the middle cerebral artery before and after hypercapnia induction. Vasomotor reactivity was defined by the breath holding index, and values under 0.69 were considered critical for VMR impairment. Vasomotor reactivity reduction was significant (P = .004) in patients with severe carotid stenosis (>70%) and with symptomatic carotid disease (P < .05). The risk factors did not significantly influence VMR reduction. Severe carotid stenosis impairs VMR and may increase the risk of stroke, especially in symptomatic patients.
我们评估了颈动脉闭塞性疾病患者脑血管对高碳酸血症的反应性。还研究了血管危险因素对颈动脉粥样硬化和脑小动脉血管舒缩反应性（VMR）的影响。纳入了颈动脉狭窄（一侧或双侧≥30%）的患者（n = 50）；30名患者作为对照。记录了高血压、高脂血症、糖尿病、心脏病、炎症和吸烟情况。通过经颅多普勒超声检查的屏气试验评估血管舒缩反应性，并通过高碳酸血症诱导前后大脑中动脉血流速度变化进行估算。血管舒缩反应性由屏气指数定义，低于0.69的值被认为对VMR损害至关重要。严重颈动脉狭窄（>70%）患者和有症状性颈动脉疾病患者的血管舒缩反应性降低显著（P = .004）（P < .05）。危险因素对VMR降低没有显著影响。严重颈动脉狭窄会损害VMR，并可能增加中风风险，尤其是有症状的患者。
