Anwar M, Vannucci R C
Department of Pediatrics (Newborn Medicine), Robert Wood Johnson Medical School, New Brunswick, New Jersey.
Pediatr Res. 1988 Jul;24(1):41-5. doi: 10.1203/00006450-198807000-00011.
To ascertain the regional cerebral blood flow (CBF) responses to hypoglycemia, nine newborn dogs were treated with insulin to blood glucose concentrations ranging from 1 to 35 mg/dl (mean 22 mg/dl). Systemic physiologic monitoring revealed no differences in mean arterial blood pressure, heart rate, paO2, paCO2, pHa, or blood lactate in the hypoglycemis animals and five normoglycemic controls. Significant increases in CBF occurred in 17 of 20 analyzed structures of brain in the hypoglycemic puppies, ranging from 158 to 446% of the normoglyycemic values. The percent increases in CBF were greatest in brainstem structures compared to other major regions of brain. A positive correlation existed between mean arterial blood pressure and cerebral cortical blood flow, suggesting a loss of CBF autoregulation during hypoglycemia. The pathophysiologic mechanism for the elevations in regional CBF might relate to stimulation of beta-adrenergic receptors in brain, as has been shown in adults.
为确定低血糖时局部脑血流量(CBF)的反应,对9只新生犬注射胰岛素,使血糖浓度维持在1至35mg/dl(平均22mg/dl)。全身生理监测显示,低血糖动物与5只血糖正常的对照动物相比,平均动脉血压、心率、动脉血氧分压(paO2)、动脉血二氧化碳分压(paCO2)、动脉血pH值(pHa)或血乳酸水平并无差异。低血糖幼犬20个分析脑区中的17个出现CBF显著增加,增幅为血糖正常时的158%至446%。与脑的其他主要区域相比,脑干结构中CBF的增加百分比最大。平均动脉血压与大脑皮质血流量之间存在正相关,提示低血糖期间CBF自身调节功能丧失。局部CBF升高的病理生理机制可能与大脑中β-肾上腺素能受体的刺激有关,这在成年动物中已有显示。