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高血压中的脑血管床及其对大脑的影响。

Cerebral vascular bed in hypertension and consequences for the brain.

作者信息

Johansson B B

出版信息

Hypertension. 1984 Nov-Dec;6(6 Pt 2):III81-6. doi: 10.1161/01.hyp.6.6_pt_2.iii81.

Abstract

The internal carotid artery of spontaneously hypertensive rats and stroke-prone spontaneously hypertensive rats has a thicker media than that of normotensive Wistar Kyoto rats as early as 15 days of age; furthermore, the media-to-lumen ratio is increased in the larger pial arteries. Since several studies have indicated that the mean arterial pressure is slightly elevated in spontaneously hypertensive rats during the early postnatal period, these vascular alterations may to some extent be related to an increased pressure load. However, it seems likely that pressure-independent genetic factors are also involved. In adult spontaneously hypertensive rats the media-to-lumen ratio in the cerebral arteries is increased over a large spectrum of vessel sizes, including the brain basal arteries. The cortical surface arteries, measured through a closed cranial window in vivo, have a smaller inner diameter in spontaneously hypertensive rats than in Wistar Kyoto under resting conditions as well as during hypercapnic vasodilation. In the relaxed cerebrovascular bed the cerebral blood flow is lower in spontaneously hypertensive rats than in Wistar Kyoto at the same perfusion pressure, which is probably due mainly to a decreased internal radius in spontaneously hypertensive rats. Since the blood flow is proportional to the fourth power of the luminal radius, the lumen reduction of cerebral arteries in spontaneously hypertensive rats and stroke-prone spontaneously hypertensive rats is a potential risk factor under conditions of impending ischemia such as systemic hypotension or distal to an arterial occlusion. On the other hand, the increased media-to-lumen ratio reduces the arterial wall tension, increases the capacity to autoregulate at high blood pressure levels, and protects the blood-brain barrier.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

早在15日龄时,自发性高血压大鼠和易卒中型自发性高血压大鼠的颈内动脉中膜就比正常血压的Wistar Kyoto大鼠厚;此外,较大的软脑膜动脉的中膜与管腔比值增加。由于多项研究表明,自发性高血压大鼠在出生后早期平均动脉压略有升高,这些血管改变可能在一定程度上与压力负荷增加有关。然而,压力独立的遗传因素似乎也参与其中。在成年自发性高血压大鼠中,包括脑基底动脉在内的各种血管大小的脑动脉中膜与管腔比值均增加。在体内通过闭合的颅骨窗口测量,自发性高血压大鼠的皮质表面动脉在静息状态以及高碳酸血症性血管舒张期间的内径均小于Wistar Kyoto大鼠。在相同的灌注压力下,在松弛的脑血管床中,自发性高血压大鼠的脑血流量低于Wistar Kyoto大鼠,这可能主要是由于自发性高血压大鼠的内半径减小。由于血流量与管腔半径的四次方成正比,自发性高血压大鼠和易卒中型自发性高血压大鼠脑动脉的管腔减小是全身低血压或动脉闭塞远端等即将发生缺血情况下的一个潜在危险因素。另一方面,增加的中膜与管腔比值可降低动脉壁张力,提高在高血压水平下的自动调节能力,并保护血脑屏障。(摘要截短于250字)

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