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低氧、高碳酸血症和高血压:它们对搏动性脑血流的影响。

Hypoxia, hypercapnia, and hypertension: their effects on pulsatile cerebral blood flow.

作者信息

Curran-Everett D, Zhang Y, Jones R H, Jones M D

机构信息

Department of Pediatrics, University of Colorado Health Sciences Center, Denver 80262, USA.

出版信息

J Appl Physiol (1985). 1995 Sep;79(3):870-8. doi: 10.1152/jappl.1995.79.3.870.

Abstract

Pulsatile cerebral blood flow reflects characteristics of arterial blood pressure as well as the structure and mechanical properties of the cerebrovascular network. Although the effects of changes in systemic blood gases and blood pressure on mean cerebral flow are established, their effects on pulsatile cerebral blood flow are unknown. These studies assessed the effects of hypoxia-hypercapnia (combined; both arterial PO2 and PCO2 approximately 55 Torr) and acute hypertension (+30-35 mmHg by aortic occlusion) on pulsatile cerebral blood flow in ketamine-anesthetized rabbits. We characterized the relationship between pulsatile systemic blood pressure (Millar catheter) and cerebral cortical capillary blood-flow (laser-Doppler) by calculating the transfer function, a frequency-domain expression that relates amplitudes and phase angles of flow output to those of the pressure input. During hypoxia-hypercapnia, mean flow increased 17% (P < 0.001), but the amplitude and contour of pulsatile cortical blood flow were unchanged (P > 0.10). Although aortic occlusion, during hypoxia-hypercapnia as well as during normoxia-normocapnia, increased systemic pulse pressure by 40%, the amplitude of cortical flow pulsations was unaffected. Changes in dynamic properties of the cerebral vasculature (P < 0.0001 by analysis of the transfer function) minimized alterations in pulsatile cortical blood flow and thus intrabeat vessel wall stress during acute hypertension; on the basis of analysis of an electrical analogue, we propose that these changes reflect alterations in both resistance and compliance.

摘要

搏动性脑血流反映了动脉血压的特征以及脑血管网络的结构和力学特性。虽然全身血气和血压变化对平均脑血流的影响已得到证实,但其对搏动性脑血流的影响尚不清楚。这些研究评估了低氧-高碳酸血症(联合;动脉血氧分压和二氧化碳分压均约为55托)和急性高血压(通过主动脉阻断使血压升高30 - 35毫米汞柱)对氯胺酮麻醉兔搏动性脑血流的影响。我们通过计算传递函数来表征搏动性全身血压(Millar导管)与大脑皮质毛细血管血流(激光多普勒)之间的关系,传递函数是一种频域表达式,它将血流输出的幅度和相位角与压力输入的幅度和相位角联系起来。在低氧-高碳酸血症期间,平均血流增加了17%(P < 0.001),但搏动性皮质血流的幅度和轮廓没有变化(P > 0.10)。尽管在低氧-高碳酸血症以及常氧-常碳酸血症期间主动脉阻断使全身脉压增加了40%,但皮质血流搏动的幅度并未受到影响。脑血管动态特性的变化(通过传递函数分析,P < 0.0001)使急性高血压期间搏动性皮质血流的改变以及因此产生的心动周期内血管壁应力最小化;基于电模拟分析,我们提出这些变化反映了阻力和顺应性的改变。

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