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急性和慢性高血压对短暂性脑缺血期间颅内侧支循环紧张度变化的影响。

Impact of Acute and Chronic Hypertension on Changes in Pial Collateral Tone In Vivo During Transient Ischemia.

机构信息

From the Departments of Neurological Sciences, Obstetrics, Gynecology and Reproductive Sciences, and Pharmacology, University of Vermont Larner College of Medicine, Burlington.

出版信息

Hypertension. 2020 Sep;76(3):1019-1026. doi: 10.1161/HYPERTENSIONAHA.120.15356. Epub 2020 Jul 20.

Abstract

We investigated vasoconstrictive responses of pial collaterals in vivo at baseline and during transient middle cerebral artery occlusion during chronic hypertension. A cranial window was used to measure diameter of leptomeningeal anastomoses (pial collaterals) in male Wistar (n=8) and spontaneously hypertensive rats (SHRs; n=8) using video dimensional analysis. Middle cerebral artery occlusion was induced by remote filament for 2 hours with 2 hours reperfusion. Phenylephrine was infused during ischemia as a pressor therapy. Active diameters of pial collaterals were significantly smaller in SHRs versus Wistar (14.1±1.5 versus 21.6±2.8 µm; <0.01); however, passive diameters were similar (25.0±2.9 versus 25.0±2.6 µm; >0.05). Basal tone of pial collaterals before occlusion was 42±5% in SHRs versus 15±4% in Wistar (<0.01). Tone decreased in both Wistar and SHRs during occlusion but remained higher in SHRs (9±2% versus 29±4%; <0.05). Phenylephrine increased blood pressure in both groups but had little effect on leptomeningeal anastomoses diameters. Reperfusion caused vasoconstriction of pial collaterals, increasing tone from 8±1% to 20±5% in Wistar and 29±5% to 44±5% in SHRs (<0.01). Higher tone in pial collaterals from SHRs basally and during occlusion/reperfusion could limit flow to the penumbra and promote evolution of infarction. Sustained elevated tone of pial collaterals from SHRs with phenylephrine suggests pressor therapy may not be appropriate during chronic hypertension.

摘要

我们研究了慢性高血压期间,活体软脑膜吻合(软脑膜侧支)在基线和短暂性大脑中动脉闭塞期间的血管收缩反应。使用视频尺寸分析,通过颅窗测量雄性 Wistar(n=8)和自发性高血压大鼠(SHR;n=8)的软脑膜吻合(软脑膜侧支)的直径。通过远程细丝将大脑中动脉闭塞诱导 2 小时,然后再灌注 2 小时。在缺血期间输注苯肾上腺素作为加压治疗。与 Wistar 相比,SHR 中的软脑膜侧支的主动直径明显较小(14.1±1.5 与 21.6±2.8 µm;<0.01);然而,被动直径相似(25.0±2.9 与 25.0±2.6 µm;>0.05)。在闭塞之前,SHR 中的软脑膜侧支的基础张力为 42±5%,而 Wistar 中的为 15±4%(<0.01)。在闭塞期间,Wistar 和 SHR 中的张力均降低,但 SHR 中的张力仍然较高(9±2%与 29±4%;<0.05)。苯肾上腺素增加了两组的血压,但对软脑膜吻合直径几乎没有影响。再灌注引起软脑膜侧支血管收缩,使 Wistar 中的张力从 8±1%增加到 20±5%,SHR 中的张力从 29±5%增加到 44±5%(<0.01)。SHR 中的软脑膜侧支的基础张力和闭塞/再灌注期间的高张力可能会限制向半影区的血流,并促进梗死的发展。SHR 中的软脑膜侧支的持续升高的张力表明,在慢性高血压期间,加压治疗可能不合适。

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