Matthews D S, Matthews J N, Aynsley-Green A, Bullock R E, Eyre J A
Department of Child Health, University of Newcastle-upon-Tyne, UK.
J Neurol Neurosurg Psychiatry. 1995 Oct;59(4):359-67. doi: 10.1136/jnnp.59.4.359.
This study examines the relation between cerebral O2 consumption (CMRO2) and the O2 consumption of the rest of the body (BVO2) after severe head injury. Seventy nine serial measurements of whole body O2 consumption, CMRO2, plasma adrenaline, T3, and glucagon concentrations were made in 15 children with severe head injuries receiving neurointensive care. Body O2 consumption was measured with indirect calorimetry and CMRO2 with the Kety-Schmidt technique. There was no evidence of a significant relation between CMRO2 and BVO2. Within each child there were statistically significant positive relations between BVO2 and adrenaline, T3, and glucagon. By contrast, there was only a weak significant positive relation between CMRO2 and T3. In conclusion, CMRO2 and BVO2 seem to be determined independently after severe head injury. Thus therapeutic measures aiming to reduce CMRO2 need to be specific to the brain and it should not be assumed that measures which decrease whole body energy expenditure will necessarily have the same effect on CMRO2.
本研究探讨了重型颅脑损伤后大脑氧耗(CMRO2)与身体其他部位氧耗(BVO2)之间的关系。对15名接受神经重症监护的重型颅脑损伤患儿进行了79次全身氧耗、CMRO2、血浆肾上腺素、T3和胰高血糖素浓度的连续测量。采用间接测热法测量身体氧耗,用凯蒂-施密特技术测量CMRO2。没有证据表明CMRO2与BVO2之间存在显著关系。在每个患儿体内,BVO2与肾上腺素、T3和胰高血糖素之间存在统计学上显著的正相关。相比之下,CMRO2与T3之间仅存在微弱的显著正相关。总之,重型颅脑损伤后CMRO2和BVO2似乎是独立决定的。因此,旨在降低CMRO2的治疗措施需要针对大脑,不应假定降低全身能量消耗的措施必然会对CMRO2产生相同的效果。