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系统性高血压患者脑血流、血管反应性及血管耦合的磁共振成像研究

MRI study of cerebral blood flow, vascular reactivity, and vascular coupling in systemic hypertension.

作者信息

Li Yunxia, Li Renren, Liu Meng, Nie Zhiyu, Muir Eric R, Duong Tim Q

机构信息

Department of Neurology, Tongji Hospital, Tongji University School of Medicine, Shanghai, China.

Department of Neurology, Tongji Hospital, Tongji University School of Medicine, Shanghai, China.

出版信息

Brain Res. 2021 Feb 15;1753:147224. doi: 10.1016/j.brainres.2020.147224. Epub 2020 Dec 23.

Abstract

Chronic hypertension alters cerebrovascular function, which can lead to neurovascular pathologies and increased susceptibility to neurological disorders. The purpose of this study was to utilize in vivo MRI methods with corroborating immunohistology to evaluate neurovascular dysfunction due to progressive chronic hypertension. The spontaneously hypertensive rat (SHR) model at different stages of hypertension was studied to evaluate: i) basal cerebral blood flow (CBF), ii) cerebrovascular reactivity (CVR) assessed by CBF and blood-oxygenation level dependent (BOLD) signal changes to hypercapnia, iii) neurovascular coupling from CBF and BOLD changes to forepaw stimulation, and iv) damage of neurovascular unit (NVU) components (microvascular, astrocyte and neuron densities). Comparisons were made with age-matched normotensive Wistar Kyoto (WKY) rats. In 10-week SHR (mild hypertension), basal CBF was higher (p < 0.05), CVR trended higher, and neurovascular coupling response was higher (p < 0.05), compared to normotensive rats. In 40-week SHR (severe hypertension), basal CBF, CVR, and neurovascular coupling response were reversed to similar or below normotensive rats, and were significantly different from 10-week SHR (p < 0.05). Immunohistological analysis found significantly reduced microvascular density, increased astrocytes, and reduced neuronal density in SHR at 40 weeks (p < 0.05) but not at 10 weeks (p > 0.05) in comparison to age-matched controls. In conclusion, we observed a bi-phasic basal CBF, CVR and neurovascular coupling response from early to late hypertension using in vivo MRI, with significant changes prior to changes in the NVU components from histology. MRI provides clinically relevant data that might be useful to characterize neurovascular pathogenesis on the brain in hypertension.

摘要

慢性高血压会改变脑血管功能,进而导致神经血管病变,并增加患神经系统疾病的易感性。本研究的目的是利用体内磁共振成像(MRI)方法并结合免疫组织学来评估进行性慢性高血压所致的神经血管功能障碍。研究了处于高血压不同阶段的自发性高血压大鼠(SHR)模型,以评估:i)基础脑血流量(CBF);ii)通过CBF以及高碳酸血症引起的脑血流量和血氧水平依赖(BOLD)信号变化评估的脑血管反应性(CVR);iii)前爪刺激引起的CBF和BOLD变化所反映的神经血管耦合;iv)神经血管单元(NVU)各组成部分(微血管、星形胶质细胞和神经元密度)的损伤情况。将其与年龄匹配的正常血压Wistar Kyoto(WKY)大鼠进行比较。在10周龄的SHR(轻度高血压)中,与正常血压大鼠相比,基础CBF较高(p < 0.05),CVR有升高趋势,神经血管耦合反应较高(p < 0.05)。在40周龄的SHR(重度高血压)中,基础CBF、CVR和神经血管耦合反应与正常血压大鼠相似或更低,且与10周龄的SHR有显著差异(p < 0.05)。免疫组织学分析发现,与年龄匹配的对照组相比,40周龄的SHR微血管密度显著降低,星形胶质细胞增多,神经元密度降低(p < 0.05),但10周龄时无此现象(p > 0.05)。总之,我们利用体内MRI观察到从早期到晚期高血压,基础CBF、CVR和神经血管耦合反应呈双相变化,且在组织学上NVU各组成部分发生变化之前就有显著改变。MRI提供了与临床相关的数据,可能有助于描述高血压患者脑部神经血管发病机制。

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