The Impact of Variational Primary Collaterals on Cerebral Autoregulation.
The Impact of Variational Primary Collaterals on Cerebral Autoregulation.
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主络变异对大脑自动调节的影响
DOI：
10.3389/fphys.2018.00759
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发表时间：
2018
影响因子：
4
通讯作者：
Yang Y
中科院分区：
文献类型：
--
作者：
Guo ZN;Sun X;Liu J;Sun H;Zhao Y;Ma H;Xu B;Wang Z;Li C;Yan X;Zhou H;Zhang P;Jin H;Yang Y
前、后交通动脉（ACoA和PCoA）对动态脑自动调节（dCA）的影响在很大程度上是未知的。在本研究中，我们旨在测试侧支解剖结构的实质性差异是否与数字减影血管造影（DSA）显示的两种常见狭窄类型的dCA差异相关：孤立性基底动脉和/或双侧椎动脉重度狭窄/闭塞（组1;组1A：双侧PCoA;组1B：无双侧PCoA），或孤立性单侧颈内动脉重度狭窄/闭塞（组2;组2A：无ACoA且有PCoA;组2B：有ACoA且无PCoA;组2C：无ACoA和PCoA）。通过传递函数分析（数学模型）计算dCA，并在大脑中动脉（MCA）和/或大脑后动脉（PCA）中进行评价。2014年至2017年间，在我们实验室接受dCA评估和DSA的总共231名非急性期缺血性中风患者中，有51名患者根据是否存在ACoA或PCoA符合入选标准，其中包括21名患者第1组，第2组30名患者。1A组和1B组之间以及2A组、2B组和2C组之间的性别、年龄和平均血压无显著差异。在第1组中，PCA相位差值（自动调节参数）显着较高的亚组与专利PCoA相比，那些没有。在第2组中，MCA相位差值在有ACoA通畅的亚组中高于无ACoA通畅的亚组。该初步研究发现，ACoA/PCoA向受影响区域的交叉流动补偿了受影响区域受损的dCA，这表明ACoA/PCoA在稳定脑血流方面具有重要作用。
The influence of the anterior and posterior communicating artery (ACoA and PCoA) on dynamic cerebral autoregulation (dCA) is largely unknown. In this study, we aimed to test whether substantial differences in collateral anatomy were associated with differences in dCA in two common types of stenosis according to digital subtraction angiography (DSA): either isolated basal artery and/or bilateral vertebral arteries severe stenosis/occlusion (group 1; group 1A: with bilateral PCoAs; and group 1B: without bilateral PCoAs), or isolated unilateral internal carotid artery severe stenosis/occlusion (group 2; group 2A: without ACoA and with PCoA; group 2B: with ACoA and without PCoAs; and group 2C: without both ACoA and PCoA). The dCA was calculated by transfer function analysis (a mathematical model), and was evaluated in middle cerebral artery (MCA) and/or posterior cerebral artery (PCA). Of a total of 231 non-acute phase ischemic stroke patients who received both dCA assessment and DSA in our lab between 2014 and 2017, 51 patients met inclusion criteria based on the presence or absence of ACoA or PCoA, including 21 patients in the group 1, and 30 patients in the group 2. There were no significant differences in gender, age, and mean blood pressure between group 1A and group 1B, and among group 2A, group 2B, and group 2C. In group 1, the PCA phase difference values (autoregulatory parameter) were significantly higher in the subgroup with patent PCoAs, compared to those without. In group 2, the MCA phase difference values were higher in the subgroup with patent ACoA, compared to those without. This pilot study found that the cross-flow of the ACoA/PCoA to the affected area compensates for compromised dCA in the affected area, which suggests an important role of the ACoA/PCoA in stabilizing cerebral blood flow.
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