Winklewski Pawel J, Tkachenko Yurii, Mazur Kamila, Kot Jacek, Gruszecki Marcin, Guminski Wojciech, Czuszynski Krzysztof, Wtorek Jerzy, Frydrychowski Andrzej F
Institute of Human Physiology, Medical University of Gdansk, Gdansk, Poland.
National Centre for Hyperbaric Medicine, Institute of Maritime and Tropical Medicine, Medical University of Gdansk, Gdynia, Poland.
PLoS One. 2015 Aug 18;10(8):e0135751. doi: 10.1371/journal.pone.0135751. eCollection 2015.
Using a novel method called near-infrared transillumination backscattering sounding (NIR-T/BSS) that allows for the non-invasive measurement of pial artery pulsation (cc-TQ) and subarachnoid width (sas-TQ) in humans, we assessed the influence of sympathetic activation on the cardiac and respiratory contribution to blood pressure (BP) cc-TQ oscillations in healthy subjects.
The pial artery and subarachnoid width response to handgrip (HGT) and cold test (CT) were studied in 20 healthy subjects. The cc-TQ and sas-TQ were measured using NIR-T/BSS; cerebral blood flow velocity (CBFV) was measured using Doppler ultrasound of the left internal carotid artery; heart rate (HR) and beat-to-beat mean BP were recorded using a continuous finger-pulse photoplethysmography; respiratory rate (RR), minute ventilation (MV), end-tidal CO2 (EtCO2) and end-tidal O2 (EtO2) were measured using a metabolic and spirometry module of the medical monitoring system. Wavelet transform analysis was used to assess the relationship between BP and cc-TQ oscillations.
HGT evoked an increase in BP (+15.9%; P<0.001), HR (14.7; P<0.001), SaO2 (+0.5; P<0.001) EtO2 (+2.1; P<0.05) RR (+9.2%; P = 0.05) and MV (+15.5%; P<0.001), while sas-TQ was diminished (-8.12%; P<0.001), and a clear trend toward cc-TQ decline was observed (-11.0%; NS). CBFV (+2.9%; NS) and EtCO2 (-0.7; NS) did not change during HGT. CT evoked an increase in BP (+7.4%; P<0.001), sas-TQ (+3.5%; P<0.05) and SaO2(+0.3%; P<0.05). HR (+2.3%; NS), CBFV (+2.0%; NS), EtO2 (-0.7%; NS) and EtCO2 (+0.9%; NS) remained unchanged. A trend toward decreased cc-TQ was observed (-5.1%; NS). The sas-TQ response was biphasic with elevation during the first 40 seconds (+8.8% vs. baseline; P<0.001) and subsequent decline (+4.1% vs. baseline; P<0.05). No change with respect to wavelet coherence and wavelet phase coherence was found between the BP and cc-TQ oscillations.
Short sympathetic activation does not affect the cardiac and respiratory contribution to the relationship between BP-cc-TQ oscillations. HGT and CT display divergent effects on the width of the subarachnoid space, an indirect marker of changes in intracranial pressure.
我们使用一种名为近红外透照背向散射探测（NIR-T/BSS）的新方法，该方法能够对人体软脑膜动脉搏动（cc-TQ）和蛛网膜下腔宽度（sas-TQ）进行无创测量，我们评估了交感神经激活对健康受试者心脏和呼吸对血压（BP）cc-TQ振荡贡献的影响。
对20名健康受试者进行了研究，观察他们软脑膜动脉和蛛网膜下腔宽度对手握力（HGT）和冷刺激试验（CT）的反应。使用NIR-T/BSS测量cc-TQ和sas-TQ；使用左侧颈内动脉多普勒超声测量脑血流速度（CBFV）；使用连续手指脉搏光电容积描记法记录心率（HR）和逐搏平均血压；使用医疗监测系统的代谢和肺活量测定模块测量呼吸频率（RR）、分钟通气量（MV）、呼气末二氧化碳（EtCO2）和呼气末氧气（EtO2）。采用小波变换分析评估血压与cc-TQ振荡之间的关系。
HGT使血压升高（+15.9%；P<0.001）、心率升高（14.7；P<0.001）、血氧饱和度升高（+0.5；P<0.001）、呼气末氧气升高（+2.！；P<0.05）、呼吸频率升高（+9.2%；P = 0.05）和分钟通气量升高（+15.5%；P<;0.001），而sas-TQ减小（-8.12%；P<0.001），并且观察到cc-TQ有明显下降趋势（-11.0%；无统计学意义）。HGT期间脑血流速度升高（+2.9%；无统计学意义）和呼气末二氧化碳降低（-0.7；无统计学意义）未发生变化。CT使血压升高（+7.4%；P<0.001）、sas-TQ升高（+3.5%；P<0.05）和血氧饱和度升高（+0.3%；P<0.05）。心率升高（+2.3%；无统计学意义）、脑血流速度升高（+2.0%；无统计学意义）、呼气末氧气降低（-0.7%；无统计学意义）和呼气末二氧化碳升高（+0.9%；无统计学意义）保持不变。观察到cc-TQ有下降趋势（-5.1%；无统计学意义）。sas-TQ反应呈双相性，最初40秒升高（+8.8%对比基线；P<0.001），随后下降（+4.1%对比基线；P<0.05）。在血压与cc-TQ振荡之间未发现小波相干性和小波相位相干性有变化。
短期交感神经激活不影响心脏和呼吸对血压-cc-TQ振荡关系的贡献。HGT和CT对蛛网膜下腔宽度显示出不同影响，蛛网膜下腔宽度是颅内压变化的一个间接指标。
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