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有先兆子痫病史的女性在进行等长握力运动时脑血流速度增加。

Augmented cerebral blood velocity in response to isometric handgrip exercise in women with a history of preeclampsia.

作者信息

Miller Kathleen B, Miller Virginia M, Harvey Ronée E, Ranadive Sushant M, Joyner Michael J, Barnes Jill N

机构信息

Bruno Balke Biodynamics Laboratory, Department of Kinesiology, University of Wisconsin-Madison, Madison, Wisconsin.

Departments of Surgery, and Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota.

出版信息

Am J Physiol Regul Integr Comp Physiol. 2019 Dec 1;317(6):R834-R839. doi: 10.1152/ajpregu.00280.2019. Epub 2019 Oct 30.

Abstract

Preeclampsia (PE) is a hypertensive disorder of pregnancy described as a condition of excessive sympathoexcitation. PE places a woman at increased risk for lifelong hypertension and cognitive impairment. Cerebral blood velocity is blunted in response to a vasoactive stimulus in women with a history of PE. This study investigated how a sympathoexcitatory stimulus affects cerebral blood velocity in women with a history of PE. Middle cerebral artery blood velocity (MCAv) and beat-to-beat mean arterial blood pressure (MAP) were measured in postmenopausal women with a history of PE ( = 21; age = 59 ± 5 yr) and a history of a normotensive pregnancy (NP; = 27; age = 58 ± 4 yr), at baseline, during isometric handgrip to fatigue (IHG) followed by postexercise ischemia (PEI), and a recovery period (REC). Baseline MAP and MAP responses to IHG and PEI did not differ between groups. MCAv at baseline and throughout the stimulus was lower in PE women compared with NP women ( < 0.05 for all). MCAv increased during IHG in both groups ( < 0.05). This increase in MCAv was greater in PE compared with NP women during IHG and REC (IHG: PE 13 ± 2% vs. NP 9 ± 2%; REC: PE 3 ± 2% vs. NP -2 ± 2%; < 0.05 for both). Thus, a history of PE is associated with low baseline cerebral blood velocity but an augmented response to a sympathoexcitatory stimulus. These changes in cerebral blood flow regulation may lead to an increased risk for cognitive impairment in women with a history of PE.

摘要

子痫前期(PE)是一种妊娠期高血压疾病,其特征为过度的交感神经兴奋。PE使女性患终身高血压和认知障碍的风险增加。有PE病史的女性在血管活性刺激下脑血流速度会减弱。本研究调查了交感神经兴奋刺激如何影响有PE病史女性的脑血流速度。在绝经后有PE病史(n = 21;年龄 = 59 ± 5岁)和血压正常妊娠(NP)病史(n = 27;年龄 = 58 ± 4岁)的女性中,于基线、等长握力至疲劳(IHG)后接着进行运动后缺血(PEI)以及恢复期(REC)期间,测量大脑中动脉血流速度(MCAv)和逐搏平均动脉血压(MAP)。两组间基线MAP以及对IHG和PEI的MAP反应无差异。与NP女性相比,PE女性在基线及整个刺激过程中的MCAv较低(所有比较P < 0.05)。两组在IHG期间MCAv均增加(P < 0.05)。在IHG和REC期间,PE女性MCAv的这种增加幅度大于NP女性(IHG:PE为13 ± 2% vs. NP为9 ± 2%;REC:PE为3 ± 2% vs. NP为 -2 ± 2%;两者均P < 0.05)。因此,PE病史与低基线脑血流速度相关,但对交感神经兴奋刺激的反应增强。脑血流调节的这些变化可能导致有PE病史女性认知障碍风险增加。

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Sympathetic responsiveness is not increased in women with a history of hypertensive pregnancy.有妊娠期高血压病史的女性,其交感神经反应性并未增强。
Am J Physiol Regul Integr Comp Physiol. 2017 Jan 1;312(1):R49-R54. doi: 10.1152/ajpregu.00379.2016. Epub 2016 Dec 7.

本文引用的文献

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No long-term impairment of cerebral autoregulation after preeclampsia.子痫前期后无长期脑自动调节功能损害。
Pregnancy Hypertens. 2018 Jul;13:171-173. doi: 10.1016/j.preghy.2018.06.009. Epub 2018 Jun 12.
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Preeclampsia and cognitive impairment later in life.子痫前期与晚年认知障碍
Am J Obstet Gynecol. 2017 Jul;217(1):74.e1-74.e11. doi: 10.1016/j.ajog.2017.03.008. Epub 2017 Mar 18.
6
Long-term cerebral white and gray matter changes after preeclampsia.子痫前期后的长期脑白质和灰质变化
Neurology. 2017 Mar 28;88(13):1256-1264. doi: 10.1212/WNL.0000000000003765. Epub 2017 Feb 24.
7
Sympathetic responsiveness is not increased in women with a history of hypertensive pregnancy.有妊娠期高血压病史的女性,其交感神经反应性并未增强。
Am J Physiol Regul Integr Comp Physiol. 2017 Jan 1;312(1):R49-R54. doi: 10.1152/ajpregu.00379.2016. Epub 2016 Dec 7.
9

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