Mendelow A D, Dharker S, Patterson J, Nath F, Teasdale G M
J Neurol Neurosurg Psychiatry. 1986 Jan;49(1):35-8. doi: 10.1136/jnnp.49.1.35.
Cerebral blood flow was measured in eight patients who were being treated with dopamine in order to maintain cerebral perfusion after the onset of delayed postoperative ischaemia following intracranial aneurysm surgery. Measurements were made whilst on treatment and repeated either during a reduction in the dosage or withdrawal of dopamine. There was a significant fall in cerebral blood flow in both hemispheres in all eight patients. Clinical deterioration was observed in seven of nine instances in which cerebral blood flow fell by 25% or more of the value while on dopamine treatment. There were no episodes of deterioration in six tests where the fall in cerebral blood flow was less than 25% of the starting value. It is suggested that cerebral blood flow measurement can be useful in predicting when it is safe to withdraw dopamine treatment in these patients. Hypertensive treatment should be maintained if a withdrawal test is associated with a fall in cerebral blood flow of 25% or more.
对8例接受多巴胺治疗的患者进行了脑血流量测量，这些患者在颅内动脉瘤手术后出现延迟性术后缺血，使用多巴胺以维持脑灌注。在治疗期间进行测量，并在多巴胺剂量减少或停用期间重复测量。所有8例患者的双侧脑血流量均显著下降。在9例脑血流量下降至多巴胺治疗时数值的25%或更多的情况中，有7例出现了临床恶化。在6次脑血流量下降小于起始值25%的测试中，没有出现恶化情况。提示脑血流量测量有助于预测这些患者何时可以安全停用多巴胺治疗。如果撤药试验导致脑血流量下降25%或更多，则应维持高血压治疗。
