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药物干预对缺血性脑卒中患者脑血流动力学的影响。

Effect of drug interventions on cerebral hemodynamics in ischemic stroke patients.

机构信息

Department of Cardiovascular Sciences, Cerebral Haemodynamics in Ageing and Stroke Medicine Research Group, University of Leicester, Leicester, UK.

Manaaki Manawa - The Centre for Heart Research, Department of Physiology, Faculty of Medical & Health Sciences, University of Auckland, Auckland, New Zealand.

出版信息

J Cereb Blood Flow Metab. 2022 Mar;42(3):471-485. doi: 10.1177/0271678X211058261. Epub 2021 Nov 5.

Abstract

The ischemic penumbra is sensitive to alterations in cerebral perfusion. A myriad of drugs are used in acute ischemic stroke (AIS) management, yet their impact on cerebral hemodynamics is poorly understood. As part of the Cerebral Autoregulation Network led INFOMATAS project (, this paper reviews some of the most common drugs a patient with AIS will come across and their potential influence on cerebral hemodynamics with a particular focus being on cerebral autoregulation (CA). We first discuss how compounds that promote clot lysis and prevent clot formation could potentially impact cerebral hemodynamics, before focusing on how the different classes of antihypertensive drugs can influence cerebral hemodynamics. We discuss the different properties of each drug and their potential impact on cerebral perfusion and CA. With emerging interest in CA status of AIS patients, either during or soon after treatment when timely reperfusion and salvageable tissue is at its most critical, the properties of these pharmacological agents may be relevant for modelling cerebral perfusion accuracy and for setting individualised treatment strategies.

摘要

缺血半影区对脑灌注的变化很敏感。在急性缺血性脑卒中(AIS)的治疗中使用了无数种药物,但它们对脑血流动力学的影响还了解甚少。作为 Cerebral Autoregulation Network 领导的 INFOMATAS 项目的一部分,本文回顾了 AIS 患者可能会遇到的一些最常见的药物及其对脑血流动力学的潜在影响,特别关注脑自动调节(CA)。我们首先讨论了促进血栓溶解和防止血栓形成的化合物如何潜在地影响脑血流动力学,然后再集中讨论不同类型的降压药物如何影响脑血流动力学。我们讨论了每种药物的不同特性及其对脑灌注和 CA 的潜在影响。随着对 AIS 患者的 CA 状态的兴趣日益浓厚,无论是在治疗期间还是在治疗后不久,及时再灌注和最关键的可挽救组织时,这些药物的特性可能与模拟脑灌注准确性和制定个体化治疗策略有关。

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