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偏瘫急性缺血性脑卒中的周围血管反应性。

Peripheral vasoreactivity in acute ischemic stroke with hemiplegia.

机构信息

Department of Neurology, Jeonbuk National University Medical School and Hospital, 20 Geonji-ro, Deokjin-gu, Jeonju, 54907, Republic of Korea.

Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea.

出版信息

Sci Rep. 2021 Apr 20;11(1):8531. doi: 10.1038/s41598-021-88050-9.

DOI:10.1038/s41598-021-88050-9
PMID:33879816
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8058338/
Abstract

The association between vasomotor tone of the peripheral arteries and cerebral hemisphere function has not been established. This study analyzed the peripheral vasoreactivity of patients with acute ischemic stroke and hemiplegia using a modified Raynaud scan, which is a new technology for blood flow measurement. In this retrospective case-control study, we examined patients with unilateral weakness consistent with ischemic lesions who underwent brain magnetic resonance imaging and modified Raynaud scanning within five days from the onset of symptoms. The modified Raynaud scan was used to quantify the radioactivity of the bilateral fingertips during rest and cooling-heating thermal stress conditions and estimate vasoreactivity based on the change in the blood amount per time under rest-thermal stress. The subjects were classified into the preserved and impaired groups based on their degrees of vasomotor reaction. Based on the modified Raynaud scanning, 37 (mean age = 69.1 ± 10.6) and 32 (mean age = 62.6 ± 11.8) subjects were allocated to the preserved and impaired groups, respectively. Binary logistic regression showed that the affected limb edema (odds ratio (OR) 6.15; confidence interval (CI) 1.40-26.97; p = 0.016) and anterior circulation (OR 3.68; CI 1.01-13.48; p = 0.049) were associated with impaired vasoreactivity. The modified Raynaud scans confirmed that central lesions in the anterior circulation with hemiparesis may influence the vasoreactivity of edematous peripheral arteries. These results may inform treatment and rehabilitation for stroke patients with hemiparesis.

摘要

外周动脉血管舒缩功能与大脑半球功能之间的关系尚未确定。本研究使用改良雷纳德扫描分析了急性缺血性脑卒中伴偏瘫患者的外周血管反应性,改良雷纳德扫描是一种新的血流测量技术。在这项回顾性病例对照研究中,我们检查了在症状发作后五天内接受脑磁共振成像和改良雷纳德扫描的单侧无力与缺血性病变一致的患者。改良雷纳德扫描用于在休息和冷却-加热热应激条件下量化双侧指尖的放射性,并根据休息-热应激下每时间的血液量变化估计血管反应性。根据血管舒缩反应的程度,将受试者分为保留组和损伤组。根据改良雷纳德扫描,37 名(平均年龄 69.1 ± 10.6)和 32 名(平均年龄 62.6 ± 11.8)患者分别被分配到保留组和损伤组。二项逻辑回归显示,受累肢体水肿(比值比(OR)6.15;置信区间(CI)1.40-26.97;p = 0.016)和前循环(OR 3.68;CI 1.01-13.48;p = 0.049)与血管反应受损相关。改良雷纳德扫描证实,前循环中的中枢病变伴偏瘫可能会影响外周水肿动脉的血管反应性。这些结果可能为偏瘫脑卒中患者的治疗和康复提供信息。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d89c/8058338/d15943580ad2/41598_2021_88050_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d89c/8058338/45b184eb4caa/41598_2021_88050_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d89c/8058338/d15943580ad2/41598_2021_88050_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d89c/8058338/45b184eb4caa/41598_2021_88050_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d89c/8058338/d15943580ad2/41598_2021_88050_Fig2_HTML.jpg

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