Ulrich P T, Becker T, Kempski O S
Neurosurgical Department, Johannes-Gutenberg-University Mainz, Germany.
J Neurol Sci. 1995 Apr;129(2):120-30. doi: 10.1016/0022-510x(94)00252-j.
The assessment of the cerebrovascular reserve capacity (RC) has become a widely used tool in the management of cerebrovascular disease. Discrepancies become obvious, however, if results obtained with different methods are compared. Aim of the present study, therefore, was to compare blood velocity and cerebral perfusion data in the same group of healthy test persons. In 32 volunteers regional cerebral blood flow (rCBF) was measured with the 133Xe-inhalation method. F1 as grey matter flow and the initial slope index (ISI) were computed. Simultaneously flow velocity in the middle cerebral artery (VMCA) was assessed by transcranial Doppler sonography (TCD). Measurements were performed in the resting state, during inhalation of 7% CO2 and after 1 g acetazolamide. Baseline VMCA was 62.38 +/- 16.1 cm/s, 90.84 +/- 23.85 cm/s during hypercapnia and 84.91 +/- 24.54 cm/s after acetazolamide. There was no significant change of baseline or stimulated values with age. F1 rose from baseline 76.25 +/- 12.48 ml/100 g/min to 103.90 +/- 14.6 ml/100 g/min in hypercapnia and to 98.4 +/- 14.9 ml/100 g/min after acetazolamide. The baseline F1 values and the response to CO2 decreased with age (p = 0.01) whereas for the acetazolamide reaction an age dependency could not be proven. ISI baseline values (41.5 +/- 6.1 ml/100 g/min) as well as those found after CO2 or acetazolamide decreased significantly with age. In hypercapnia changes of F1 and ISI were not too well related with changes of VMCA (F1: r = 0.599; ISI: r = 0.473), but better during acetazolamide exposure (F1: r4 = 0.715; ISI: r = 0.522). The age dependency of resting and stimulated values has to be considered when assessing the reserve capacity. There is a correlation between changes of the perfusion and flow parameters in healthy individuals which, however, may be worse in cerebrovascular disease.
脑血管储备能力(RC)评估已成为脑血管疾病管理中广泛应用的一项工具。然而,如果比较不同方法所获得的结果,差异就会变得明显。因此,本研究的目的是比较同一组健康受试人员的血流速度和脑灌注数据。对32名志愿者采用133Xe吸入法测量局部脑血流量(rCBF)。计算出灰质血流量F1和初始斜率指数(ISI)。同时,通过经颅多普勒超声(TCD)评估大脑中动脉的血流速度(VMCA)。测量在静息状态下、吸入7%二氧化碳期间以及服用1g乙酰唑胺后进行。静息状态下VMCA为62.38±16.1cm/s,高碳酸血症时为90.84±23.85cm/s,服用乙酰唑胺后为84.91±24.54cm/s。基线值或刺激值均未随年龄出现显著变化。F1从静息状态下的76.25±12.48ml/100g/min在高碳酸血症时升至103.90±14.6ml/100g/min,服用乙酰唑胺后升至98.4±14.9ml/100g/min。F1的基线值及对二氧化碳的反应随年龄下降(p = 0.01),而对于乙酰唑胺反应,未证实存在年龄依赖性。ISI的基线值(41.5±6.1ml/100g/min)以及二氧化碳或乙酰唑胺作用后的数值均随年龄显著下降。在高碳酸血症时,F1和ISI的变化与VMCA的变化相关性不太好(F1:r = 0.599;ISI:r = 0.473),但在服用乙酰唑胺期间相关性更好(F1:r4 = = 0.715;ISI:r = 0.522)。在评估储备能力时,必须考虑静息和刺激值的年龄依赖性。健康个体的灌注和血流参数变化之间存在相关性,然而,在脑血管疾病中这种相关性可能更差。