急性脑损伤患者的过度通气诱发脑缺血：氙增强CT证实
Hyperventilation-induced cerebral ischemia in patients with acute brain lesions: demonstration by xenon-enhanced CT.
作者信息
Stringer W A, Hasso A N, Thompson J R, Hinshaw D B, Jordan K G
机构信息
Department of Radiology, Loma Linda University Medical Center, CA 92350.
出版信息
AJNR Am J Neuroradiol. 1993 Mar-Apr;14(2):475-84.
PURPOSE
To examine the possibility that hyperventilation, commonly used to prevent or treat increased intracranial pressure in patients with acute brain lesions, may induce significant cerebral ischemia.
METHODS
Local cerebral blood flow and vascular reactivity were measured before and after hyperventilation using xenon-enhanced CT in 12 patients with acute brain lesions.
RESULTS
Five patients showed "paradoxical" reactivity (increased cerebral blood flow during hyperventilation) within the lesions. In five patients, hyperventilation induced ischemia in apparently normal regions of brain. In three patients, areas of luxury perfusion became ischemic during hyperventilation, while in three patients, lesions with moderate ischemia became more ischemic. Most patients showed more than one type of reactivity.
CONCLUSIONS
These findings document hyperventilation-induced ischemia in acute brain lesions, and demonstrate that this phenomenon affects both injured and apparently intact areas of the brain. Further studies are required to determine the clinical significance of these pathophysiologic changes.
目的
探讨常用于预防或治疗急性脑损伤患者颅内压升高的过度通气是否可能诱发显著的脑缺血。
方法
使用氙增强CT对12例急性脑损伤患者在过度通气前后测量局部脑血流量和血管反应性。
结果
5例患者在病变内表现出“反常”反应（过度通气时脑血流量增加）。5例患者中，过度通气在大脑明显正常区域诱发了缺血。3例患者中，过度灌注区域在过度通气时变为缺血，而3例中度缺血的病变在过度通气时缺血加重。大多数患者表现出不止一种类型的反应。
结论
这些发现证明了急性脑损伤中过度通气诱发的缺血，并表明这种现象影响大脑的损伤区域和明显完整的区域。需要进一步研究以确定这些病理生理变化的临床意义。
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