Holzschuh M, Woertgen C, Metz C, Brawanski A
Department of Neurosurgery, University of Regensburg, Federal Republic of Germany.
Acta Neurochir (Wien). 1997;139(1):58-62. doi: 10.1007/BF01850869.
The present study compares the change of cerebral blood flow and HbO2 measured by near-infrared spectroscopy (NIRS) after administration of 1000 mg acetazolamide intravenously. CBF studies in 21 patients with ischaemic cerebrovascular disease were performed routinely with the 133Xenon technique. Additionally the local HbO2 was recorded by NIRS. A rest study was followed by a second study after the administration of 1000 mg acetazolamide. In 18 patients we observed an increase of 30.8% of CBF and 4.7% of HbO2, 3 patients showed a decrease of CBF and 2 patients a simultaneous decrease of HbO2. We did not find a correlation between the absolute values of CBF and HbO2 at rest or after stimulation. However, a positive correlation (r = 0.71, p < 0.05) between the change of CBF and HbO2 could be detected. Assuming a threshold value of normal CBF reactivity of 30% and 4% HbO2 reactivity we found for NIRS a sensitivity of 0.88 and a specificity of 0.75. The results demonstrate that changes of CBF can be detected with NIRS and the algorithm of the used monitor is able to calculate the intracranial part of the signal. So, NIRS can be used as non-invasive screening method to test the cerebrovascular reserve capacity.
本研究比较了静脉注射1000毫克乙酰唑胺后，通过近红外光谱法（NIRS）测量的脑血流量和血红蛋白氧（HbO2）的变化。对21例缺血性脑血管疾病患者，常规采用133氙技术进行脑血流量研究。此外，通过近红外光谱法记录局部血红蛋白氧（HbO2）。在静息状态下进行一项研究，之后在注射1000毫克乙酰唑胺后进行第二项研究。在18例患者中，我们观察到脑血流量增加了30.8%，血红蛋白氧（HbO2）增加了4.7%；3例患者脑血流量减少，2例患者血红蛋白氧（HbO2）同时减少。我们未发现静息状态或刺激后脑血流量和血红蛋白氧（HbO2）绝对值之间存在相关性。然而，可检测到脑血流量变化与血红蛋白氧（HbO2）变化之间存在正相关（r = 0.71，p < 0.05）。假设正常脑血流量反应性的阈值为30%，血红蛋白氧（HbO2）反应性的阈值为4%，我们发现近红外光谱法的敏感性为0.88，特异性为0.75。结果表明，近红外光谱法可检测脑血流量的变化，且所用监测仪的算法能够计算信号的颅内部分。因此，近红外光谱法可作为一种非侵入性筛查方法来检测脑血管储备能力。
