Sugimori H, Ibayashi S, Irie K, Ooboshi H, Nagao T, Fujii K, Sadoshima S, Fujishima M
Second Department of Internal Medicine, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Stroke. 1994 Jul;25(7):1384-9. doi: 10.1161/01.str.25.7.1384.
The present study was designed to examine cerebral hemodynamics in early and chronic stages of hypertension using transcranial Doppler sonography.
Our study population consisted of 16 chronic hypertensive patients with chronic and small deep brain infarction, 10 young early-stage hypertensive subjects, and 16 young normotensive healthy volunteers. Using three-dimensional mapping techniques, we identified the M1 portion of the middle cerebral arteries and measured mean blood flow velocity, and we calculated the Gosling pulsatility index (PI), Fourier PI of the first harmonic (Fourier PI1), and cerebrovascular resistance.
Mean blood flow velocity in the young hypertensive group was statistically higher (71.7 +/- 11.7 cm/s [mean +/- SD]) than among chronic hypertensive subjects (56.9 +/- 21.4 cm/s, P < .01) and normotensive subjects (63.2 +/- 11.8 cm/s, P < .05). Gosling PI presented a mirror image of mean blood flow velocity in both hypertensive and normotensive subjects. Chronic hypertensive subjects showed significantly higher Fourier PI1 (0.32 +/- 0.05) and cerebrovascular resistance (2.08 +/- 0.82 mm Hg/cm per second) than normotensive subjects (0.25 +/- 0.03 and 1.31 +/- 0.23 mm Hg/cm per second [P < .005], respectively) or early-stage hypertensive subjects (0.25 +/- 0.04 and 1.44 +/- 0.26 mm Hg/cm per second [P < .02], respectively).
Early-stage hypertensive subjects demonstrated higher velocity, normal Fourier PI1, and near normal vascular resistance, whereas chronic hypertensive subjects showed near normal velocity, higher Fourier PI, and greater vascular resistance. Results may indicate different degrees of cerebral arteriopathy and arteriolopathy between early and late stages of hypertension.
本研究旨在使用经颅多普勒超声检查高血压早期和慢性期的脑血流动力学。
我们的研究对象包括16例患有慢性小深部脑梗死的慢性高血压患者、10例年轻的高血压早期受试者和16例年轻的血压正常健康志愿者。使用三维映射技术，我们确定了大脑中动脉的M1段并测量了平均血流速度，还计算了戈斯林搏动指数（PI）、基波傅里叶PI（傅里叶PI1）和脑血管阻力。
年轻高血压组的平均血流速度在统计学上高于慢性高血压受试者（56.9±21.4 cm/s，P <.01）和血压正常受试者（63.2±11.8 cm/s，P <.05）（71.7±11.7 cm/s [平均值±标准差]）。在高血压和血压正常的受试者中，戈斯林PI呈现出平均血流速度的镜像。慢性高血压受试者的傅里叶PI1（0.32±0.05）和脑血管阻力（2.08±0.82 mmHg/cm每秒）显著高于血压正常受试者（分别为0.25±0.03和1.31±0.23 mmHg/cm每秒 [P <.005]）或高血压早期受试者（分别为0.25±0.04和1.44±0.26 mmHg/cm每秒 [P <.02]）。
高血压早期受试者表现出较高的速度、正常的傅里叶PI1和接近正常的血管阻力，而慢性高血压受试者表现出接近正常的速度、较高的傅里叶PI和较大的血管阻力。结果可能表明高血压早期和晚期之间存在不同程度的脑动脉病和小动脉病。
