Burtsev E M, Molokov D D
Zh Nevropatol Psikhiatr Im S S Korsakova. 1986;86(9):1305-10.
The authors studied the parameters of the central and cerebral hemodynamics in 66 males aged 38-58 years who were treated at a health resort for initial manifestations of cerebral circulation insufficiency (CCI). A test with graded exercise (GE) revealed in all patients an increase in the total peripheral vascular resistance (TPVR) which was the greatest in cases of initial manifestations of CCI due to borderline arterial hypertension (AH). In the period of recovery and following the nitroglycerin test the TPVR returned to the initial level in patients with AH and vegetovascular dystonia whereas there was no such decrease in patients with initial cerebral atherosclerosis. Already at the 1st minute of the recovery period following GE patients with atherosclerosis (A) and essential hypertension (EH) presented a considerable increase in the arterial tone (AT) which remained stable even after 10 min of rest. These changes in AT indicated a decrease in the adaptational possibilities of the cerebral hemodynamics and simultaneously made it possible to differentiate them from vegetovascular dystonia when AT increased insignificantly only during the first min after GE and then rapidly returned to the initial level and diminished even more during the nitroglycerin test. The proposed method of comprehensive examination of parameters of the central and cerebral hemodynamics when combined with neuropsychological findings makes it possible not only to improve the diagnosis of diseases responsible for initial manifestations of CCI but also to considerably increase the objectivity of the assessment of the sanatorium treatment.
作者对66名年龄在38 - 58岁的男性进行了研究,这些男性因脑循环不全(CCI)的初始表现而在疗养院接受治疗。分级运动(GE)测试显示,所有患者的总外周血管阻力(TPVR)均增加,在因临界动脉高血压(AH)导致CCI初始表现的病例中增加最为显著。在恢复期间以及进行硝酸甘油测试后,AH和植物神经血管性肌张力障碍患者的TPVR恢复到初始水平,而初始脑动脉粥样硬化患者则没有这种下降。在GE后的恢复期第1分钟,患有动脉粥样硬化(A)和原发性高血压(EH)的患者的动脉张力(AT)就出现了显著增加,即使休息10分钟后仍保持稳定。AT的这些变化表明脑血流动力学的适应可能性降低,同时也使得能够将其与植物神经血管性肌张力障碍区分开来,后者在GE后仅在第1分钟内AT略有增加,然后迅速恢复到初始水平,在硝酸甘油测试期间甚至进一步降低。所提出的综合检查中枢和脑血流动力学参数的方法,与神经心理学结果相结合,不仅能够改善对导致CCI初始表现的疾病的诊断,还能显著提高疗养院治疗评估的客观性。