摘要
目的采用近红外光谱分析技术,研究单侧颈动脉重度狭窄患者脑血流自动调节功能(CA)。方法以2015年1月至2017年2月在北京电力医院行全身麻醉手术的30例患者为研究对象,其中,15例单侧颈动脉重度狭窄患者为狭窄组,15例无颈动脉狭窄患者为对照组,两组患者性别和年龄相匹配。在稳定的全身麻醉状态下,同时记录脑组织氧饱和指数(TOI)和平均动脉压,计算相关系数r,根据r值判断CA状态。结果狭窄组患者狭窄侧与非狭窄侧的TOI差异无统计学意义(66.52±6.50比65.23±4.50;t=0.93,P=0.368),狭窄组狭窄侧与对照组同一侧的TOI差异也无统计学意义(66.52±6.50比64.22±3.87;t=1.18,P=0.248)。狭窄组狭窄侧和非狭窄侧的r值分别为0.36±0.12和0.17±0.11,狭窄组狭窄侧和对照组同一侧的r值分别为0.36±0.12和0.13±0.08。术前3个月内,狭窄组15例患者中,5例有短暂性脑缺血发作,2例有脑梗病史。将r值为0.342作为评估CA异常的判断点时,其敏感性为0.625,特异性为0.909。结论在正常血压波动范围内,单侧颈动脉重度狭窄患者狭窄侧的脑血流和血压有一定的相关性。
Objective To investigate cerebral autoregulation(CA)in patients with severe unilateral carotid artery stenosis by near infrared spectroscopy.Methods Thirty patients who underwent general anesthesia in our hospital from January 2015 to February 2017 were enrolled in this study.The stenosis group included 15 patients with severe unilateral internal carotid artery stenosis,and the control group included 15 patients without carotid artery stenosis.Both groups were matched in sex and age.Cerebral tissue oxygenation index(TOI)and mean arterial pressure were recorded continuously under stable general anesthesia.The Pearson correlation coefficient(r)was calculated to judge the CA status.Results TOI was not significantly different between the stenosis side and the non-stenosis side in the stenosis group(66.52±6.50 vs.65.23±4.50;t=0.93,P=0.368)or between the stenosis side in the stenosis group and the stenosis side in the control group(66.52±6.50 vs.64.22±3.87;t=1.18,P=0.248).The r values of stenosis side and non-stenosis side in the stenosis group were 0.36±0.12 and 0.17±0.11,respectively,and the r values of the stenosis side in the stenosis group and the stenosis side of the control group were 0.36±0.12 and 0.13±0.08,respectively.In the stenosis group,5 patients had transient ischemic attack and 2 patients had a history of stroke within 3 months before operation.When an r value of 0.342 was used as the judgment point of CA abnormality,the sensitivity and specificity were 0.625 and 0.909,respectively.Conclusion Within the range of normal blood pressure fluctuation,cerebral blood flow is linked to blood pressure at the stenosis side in patients with severe unilateral carotid artery stenosis.
作者
于丽云
孙立智
王飞
赵晓燕
韩文勇
YU Liyun;SUN Lizhi;WANG Fei;ZHAO Xiaoyan;HAN Wenyong(Department of Anesthesia,Beijing Electric Power Hospital,Beijing 100073,China)
出处
《中国医学科学院学报》
CAS
CSCD
北大核心
2020年第3期327-330,共4页
Acta Academiae Medicinae Sinicae
关键词
颈动脉狭窄
脑血流自动调节功能
平均动脉压
脑组织氧饱和指数
carotid artery stenosis
cerebral autoregulation
mean arterial pressure
cerebral tissue oxygenation index
