Kramer M S, Vinall P E, Katolik L I, Simeone F A
Neuroscience Research Institute, Pennsylvania Hospital, Philadelphia, USA.
Neurosurgery. 1996 Feb;38(2):355-61. doi: 10.1097/00006123-199602000-00024.
Laser-Doppler flowmetry provides a continuous measurement of blood flow without violating the natural state of circulation. The linearity of the laser-Doppler and hydrogen clearance methods of blood flow measurement were compared using a protocol that produced changes in cerebral blood flow that might be experienced in a neurosurgical setting. Cerebral blood flow was measured in both hemispheres of 12 adult cats during the snaring of one common carotid artery, the intracisternal injection of 5 mg of 5-hydroxytryptamine creatinine sulfate, and hypervolemic hemodilution, which produced a 25% reduction in blood hematocrit. The percentage of baseline laser-Doppler flowmetry and hydrogen clearance flows showed an acceptable degree of correlation (R2 = 0.762) over the range of cerebral blood flows measured. More rigorous analysis using Bland and Altman's difference against mean test showed that 10 minutes after hemodilution, the two methods displayed a level of variation outside the limits of agreement (-21.85 to 22.03%). Laser-Doppler flowmetry provided a noninvasive and continuous measure of blood flow, increasing the ability to observe instantaneous changes in cerebral microcirculation. However, laser-Doppler flowmetry did not record absolute blood flow, was affected by cerebral tissue shrinkage, and did not accurately measure flow under conditions of changed blood hematocrit.
激光多普勒血流仪能够在不破坏自然循环状态的情况下连续测量血流。使用一种能产生在神经外科手术环境中可能出现的脑血流变化的方案,比较了激光多普勒血流测量方法和氢清除法的线性。在12只成年猫的两侧大脑半球进行脑血流测量,测量过程包括钳夹一条颈总动脉、脑池内注射5毫克硫酸5-羟色胺肌酐以及进行使血细胞比容降低25%的高血容量血液稀释。在所测量的脑血流范围内,激光多普勒血流测量法和氢清除法的基线血流百分比显示出可接受程度的相关性(R2 = 0.762)。使用布兰德和奥特曼的差值与均值检验进行的更严格分析表明,血液稀释10分钟后,这两种方法显示出的变化水平超出了一致性界限(-21.85%至22.03%)。激光多普勒血流仪提供了一种无创且连续的血流测量方法,增强了观察脑微循环瞬时变化的能力。然而,激光多普勒血流仪无法记录绝对血流,受脑组织收缩影响,并且在血细胞比容改变的情况下不能准确测量血流。