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脑皮质毛细血管血流的视频显微镜检查:对低血压和颅内高压的反应

Video microscopy of cerebrocortical capillary flow: response to hypotension and intracranial hypertension.

作者信息

Hudetz A G, Fehér G, Weigle C G, Knuese D E, Kampine J P

机构信息

Department of Anesthesiology, Medical College of Wisconsin, Milwaukee 53226, USA.

出版信息

Am J Physiol. 1995 Jun;268(6 Pt 2):H2202-10. doi: 10.1152/ajpheart.1995.268.6.H2202.

Abstract

Although autoregulation of cerebral blood flow is well established, the response of cerebral capillary circulation to reduced cerebral perfusion pressure (CPP) is unclear. The objective of this study was to determine whether red cell flow velocity in individual capillaries of the cerebral cortex is maintained during acute decreases in CPP. Microcirculation of the superficial parietal cerebral cortex of adult barbiturate-anesthetized artificially ventilated rats was visualized using a new design of closed-perfused cranial window and epifluorescent-intensified video microscopy. Fluorescein-isothiocyanate-labeled red blood cells (FRBC) injected intravenously were used as markers of capillary flow. CPP, defined as mean arterial pressure minus intracranial pressure, was reduced by controlled hemorrhage or by stepwise elevation of local intracranial pressure. The movement of FRBC in the parenchymal capillary network was video recorded at each pressure level, and FRBC velocity in each capillary was measured off-line with use of the dual-window digital cross-correlation technique. FRBC flux in the capillaries was measured by automated cell counting. FRBC velocity at normal perfusion pressure was 1.47 +/- 0.58 (SD) mm/s and changed little in the perfusion pressure range of 70-120 mmHg. The autoregulatory index in this pressure range was 0.0049 mm.s-1.mmHg-1. Opening of previously unperfused capillaries was not observed. FRBC flux correlated with FRBC velocity, but the latter was maintained in a narrower range than FRBC flux, suggesting a decrease in capillary diameter or hematocrit with decreasing perfusion pressure. The results suggest that flow autoregulation is associated with the maintenance of capillary flow velocity and that capillary recruitment does not contribute to flow autoregulation in the rat cerebral cortex.

摘要

尽管脑血流量的自动调节机制已得到充分证实,但脑毛细血管循环对降低的脑灌注压(CPP)的反应尚不清楚。本研究的目的是确定在CPP急性降低期间,大脑皮质单个毛细血管中的红细胞流速是否能维持。使用一种新设计的封闭灌注颅窗和落射荧光增强视频显微镜,对成年巴比妥麻醉、人工通气大鼠的顶叶大脑皮质浅层微循环进行可视化观察。静脉注射异硫氰酸荧光素标记的红细胞(FRBC)作为毛细血管血流的标志物。通过控制性出血或逐步升高局部颅内压来降低CPP,CPP定义为平均动脉压减去颅内压。在每个压力水平下,对实质毛细血管网络中FRBC的运动进行视频记录,并使用双窗口数字互相关技术离线测量每个毛细血管中的FRBC流速。通过自动细胞计数测量毛细血管中的FRBC通量。正常灌注压下FRBC流速为1.47±0.58(SD)mm/s,在70 - 120 mmHg灌注压范围内变化不大。该压力范围内的自动调节指数为0.0049 mm·s⁻¹·mmHg⁻¹。未观察到先前未灌注的毛细血管开放。FRBC通量与FRBC流速相关,但后者维持在比FRBC通量更窄的范围内,表明随着灌注压降低毛细血管直径或血细胞比容减小。结果表明,血流自动调节与毛细血管流速的维持有关,并提示在大鼠大脑皮质中毛细血管募集对血流自动调节无贡献。

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