Hegeduš Ivana, Milić Jakov, Ćosić Anita, Buljan Krunoslav, Drenjančević Ines
a Department of Neurology , Osijek University Hospital , Osijek , Croatia.
b Department of Physiology and Immunology, Faculty of Medicine Osijek , Josip Juraj Strossmayer University of Osijek , Osijek , Croatia.
Brain Inj. 2017;31(4):560-566. doi: 10.1080/02699052.2017.1280853. Epub 2017 Mar 13.
This study aimed to assess the effect of acute hyperoxia on cerebral and systemic heamodynamics and the plasma concentration of prostacyclin and thromboxane in patients with stroke.
Mean blood flow velocity (MBFV), pulsatility and resistance indices of the middle cerebral artery using transcranial Doppler ultrasound before and during acute hyperoxia (4 L of 100%O/15' over facial mask) in 92 participants - 25 patients with acute ischaemic stroke (AIS) that occurred within 72 hours and diabetes mellitus (SPDM), 26 AIS patients without DM (SP) and in 41 healthy controls (HS), were measured. Partial pressure of O (pO), blood pressure and heart rate were measured using pulse oxymeter and pressure gauge, respectively. All the above measurements, as well as cerebral vasoreactivity assessments were performed, before, at the end of the 15 minute period of hyperoxia, and 15 minutes after hyperoxia. The plasma concentration of thromboxane and prostacyclin were determined by ELISA assays.
MBFV increased in both SP and SPDM, while MBFV decreased in HS in response to hyperoxia. Thromboxane correlated negatively and prostacyclin positively with MBVF in the SPDM, although their concentrations did not differ significantly after hyperoxia among groups.
Results suggest impaired vascular reactivity to acute hyperoxia in patients with stroke and the possible role of thromboxane A2/prostacycline in mediating cerebrovascular reactivity in SPDM.
ANG, II angiotensin II; ASA, acetylsalicylic acid; ATP, Adenosine triphosphate; BP, blood pressure; CBF, cerebral blood flow; CDI, colour Doppler imaging; COX, cyclooxigenase; COVR, cerebrovascular oxygen vasoreactivity; CVR, cerebrovascular reactivity; HR, heart rate; HS, healthy subjects; MBFV, mean blood flow velocity; MCA, middle cerebral artery; PG, 6-keto-PGF1alfa; PGI2, prostacycline; PI, pulsatility index; pO partial pressure of O; RI, resistance index; ROS, reactive oxygen species; SP, stroke patients; TCD, transcranial doppler; TXA, thromboxane A2; TXB, thromboxane B2; VSMC, vascular smooth muscle cell; 20-HETE, 20-hydroxieicosatetraenoic acid.
本研究旨在评估急性高氧对中风患者脑和全身血流动力学以及血浆前列环素和血栓素浓度的影响。
对92名参与者进行研究，其中包括25名在72小时内发生急性缺血性中风（AIS）且患有糖尿病（SPDM）的患者、26名无糖尿病的AIS患者（SP）以及41名健康对照者（HS）。使用经颅多普勒超声在急性高氧（通过面罩给予4升100%氧气，持续15分钟）前及期间测量大脑中动脉的平均血流速度（MBFV）、搏动指数和阻力指数。分别使用脉搏血氧仪和压力计测量氧分压（pO）、血压和心率。在高氧15分钟期间结束时、高氧后15分钟以及高氧前进行上述所有测量以及脑血管反应性评估。通过酶联免疫吸附测定法测定血栓素和前列环素的血浆浓度。
高氧时，SP和SPDM组的MBFV均升高，而HS组的MBFV降低。在SPDM组中，血栓素与MBFV呈负相关，前列环素与MBFV呈正相关，尽管高氧后各组之间它们的浓度差异不显著。
结果表明中风患者对急性高氧的血管反应性受损，并且血栓素A2/前列环素在介导SPDM患者脑血管反应性中可能发挥作用。
ANG，II血管紧张素II；ASA，乙酰水杨酸；ATP，三磷酸腺苷；BP，血压；CBF，脑血流量；CDI，彩色多普勒成像；COX，环氧化酶；COVR，脑血管氧血管反应性；CVR，脑血管反应性；HR，心率；HS，健康受试者；MBFV，平均血流速度；MCA，大脑中动脉；PG，6-酮-前列腺素F1α；PGI2，前列环素；PI，搏动指数；pO氧分压；RI，阻力指数；ROS，活性氧；SP，中风患者；TCD经颅多普勒；TXA，血栓素A2；TXB，血栓素B2；VSMC，血管平滑肌细胞；20-HETE，20-羟基二十碳四烯酸。
