Berkowitz I D, Hayden W R, Traystman R J, Jones M D
Department of Anesthesiology/Critical Care Medicine and Pediatrics, Johns Hopkins Medical Institutions, Baltimore, Maryland 21287.
Pediatr Res. 1993 Jan;33(1):48-51. doi: 10.1203/00006450-199301000-00010.
To examine the mechanisms of autoregulatory impairment in meningitis, we studied the effects of Haemophilus influenzae type b (Hib) on pial vessels during hemorrhagic hypotension in rats, using a cranial window technique. We prepared cranial windows in barbiturate-anesthetized, mechanically ventilated rats. Artificial cerebrospinal fluid or 10(5) Hib in cerebrospinal fluid (n = 7 each group) was suffused over the pial surface. Pial arteriolar diameter was measured hourly for 4 h. Autoregulation was assessed as the ability of pial arterioles to dilate in response to graded hemorrhagic hypotension at 2 and 4 h. Pial arterioles exposed to Hib dilated progressively to 149 +/- 27% of baseline at 4 h. Vessel diameter in the Hib group was significantly greater than in the control group beginning at 2 h. Autoregulation was progressively impaired in Hib-exposed rats compared with control rats [-5.85 +/- 1.38 versus -8.02 +/- 2.02 and -3.82 +/- 1.57 versus -8.53 +/- 1.72% dilation/kPa fall in mean arterial blood pressure at 2 and 4 h, respectively (p < 0.05)]. These data suggest that autoregulation is impaired in pial arterioles exposed to Hib because involved vessels have a finite dilatory capacity and are close to maximal dilation before hypotensive challenge.
为研究脑膜炎中自动调节功能受损的机制,我们采用颅窗技术,研究了b型流感嗜血杆菌(Hib)对大鼠出血性低血压期间软脑膜血管的影响。我们在巴比妥麻醉、机械通气的大鼠中制备了颅窗。将人工脑脊液或脑脊液中含有10(5) Hib的溶液(每组n = 7)灌注到软脑膜表面。每小时测量软脑膜小动脉直径,持续4小时。在2小时和4小时时,通过软脑膜小动脉对分级出血性低血压的扩张反应能力来评估自动调节功能。暴露于Hib的软脑膜小动脉在4小时时逐渐扩张至基线的149±27%。从2小时开始,Hib组的血管直径明显大于对照组。与对照组大鼠相比,暴露于Hib的大鼠的自动调节功能逐渐受损[在2小时和4小时时,平均动脉血压每下降1 kPa,扩张百分比分别为-5.85±1.38与-8.02±2.02,以及-3.82±1.57与-8.53±1.72%(p < 0.05)]。这些数据表明,暴露于Hib的软脑膜小动脉的自动调节功能受损,因为受累血管具有有限的扩张能力,并且在低血压挑战前已接近最大扩张。