Kusunoki M, Kimura K, Nakamura M, Isaka Y, Yoneda S, Abe H
J Cereb Blood Flow Metab. 1981;1(4):413-7. doi: 10.1038/jcbfm.1981.45.
The contribution of hematocrit (Ht) changes on cerebral blood flow (CBF) and brain oxygenation in ischemic cerebrovascular disease is still controversial. In the present study, effects of Ht variations of CBF and oxygen delivery were investigated in patients with ischemic cerebrovascular disease. CBF was measured by the Xe-133 intracarotid injection method in 27 patients, whose diagnoses included completed stroke, reversible ischemic neurological deficit, and transient ischemic attack. Ht values in the patients ranged from 31 to 53%. There was a significant inverse correlation between CBF and Ht in these Ht ranges. Oxygen delivery, i.e., the product of arterial oxygen content and CBF, increased with Ht elevation and reached the maximum level in the Ht range of 40-45% and then declined. The CBF-Ht and oxygen transport-Ht relations observed in our study were similar to those in the glass-tube model studies by other workers rather than to those in intact animal experiments. From these results, it is conceivable that in ischemic cerebrovascular disease, the vasomotor adjustment was impaired in such a manner that the relations among Ht, CBF, and oxygen delivery were different from those in healthy subjects. Further, an "optimal hematocrit" for brain oxygenation was also discussed.
血细胞比容（Ht）变化对缺血性脑血管病患者脑血流量（CBF）及脑氧合的影响仍存在争议。在本研究中，我们对缺血性脑血管病患者Ht变化对CBF及氧输送的影响进行了研究。采用氙-133颈内动脉注射法对27例患者的CBF进行了测量，这些患者的诊断包括完全性卒中、可逆性缺血性神经功能缺损及短暂性脑缺血发作。患者的Ht值范围为31%至53%。在这些Ht范围内，CBF与Ht之间存在显著的负相关。氧输送，即动脉血氧含量与CBF的乘积，随Ht升高而增加，并在Ht为40%至45%时达到最高水平，随后下降。我们研究中观察到的CBF-Ht及氧输送-Ht关系与其他研究者在玻璃管模型研究中的结果相似，而非与完整动物实验中的结果相似。从这些结果可以推测，在缺血性脑血管病中，血管运动调节受损，使得Ht、CBF及氧输送之间的关系与健康受试者不同。此外，还讨论了脑氧合的“最佳血细胞比容”。
