Selective neuronal damage and blood pressure in atherosclerotic major cerebral artery disease.
Selective neuronal damage and blood pressure in atherosclerotic major cerebral artery disease.
复制标题
动脉粥样硬化性大脑动脉疾病中的选择性神经元损伤和血压。
DOI：
10.1136/jnnp-2019-320326
复制
发表时间：
2019
期刊：
影响因子：
--
通讯作者：
Okuyama C.
中科院分区：
文献类型：
--
作者：
1.Yamauchi H;Kagawa S;Takahashi M;Kusano K;Okuyama C.
在动脉粥样硬化性脑大动脉疾病患者中，低血压可能会损害脑灌注，从而加剧选择性神经元损伤的风险。本回顾性研究的目的是确定是否在后续低血压与增加选择性神经元damage.MethodsWe回顾性分析数据从76例药物治疗的患者动脉粥样硬化颈内动脉或大脑中动脉疾病，没有缺血发作的后续6个月或以上。所有患者均使用正电子发射断层扫描和11 C-氟马西尼两次测量中枢苯二氮卓受体的分布。使用三维立体定向表面投影，我们量化了大脑中动脉分布内大脑皮质苯二氮卓类受体的异常减少，并将苯二氮卓类受体指数的这些变化与随访检查时的血压值相关联。（平均27±21个月）与随访时的收缩压呈负相关。在基线时有和无脑血流量减少的患者中，苯二氮卓类受体指数变化与收缩压之间的关系不同（相互作用，p<0.005）。苯二氮卓类受体指数（神经元损伤）的较大增加，观察到在较低的收缩压水平的患者脑血流量减少比患者没有这样的decreases.ConclusionIn患者无缺血性中风发作，但在后续的脑血流量减少，由于动脉疾病，低收缩压在后续可能与增加选择性神经元损伤。
ObjectiveIn patients with atherosclerotic major cerebral artery disease, low blood pressure might impair cerebral perfusion, thereby exacerbate the risk of selective neuronal damage. The purpose of this retrospective study was to determine whether low blood pressure at follow-up is associated with increased selective neuronal damage.MethodsWe retrospectively analysed data from 76 medically treated patients with atherosclerotic internal carotid artery or middle cerebral artery disease with no ischaemic episodes on a follow-up of 6 months or more. All patients had measurements of the distribution of central benzodiazepine receptors twice using positron emission tomography and11C-flumazenil. Using three-dimensional stereotactic surface projections, we quantified abnormal decreases in the benzodiazepine receptors of the cerebral cortex within the middle cerebral artery distribution and correlated these changes in the benzodiazepine receptors index with blood pressure values at follow-up examinations.ResultsThe changes in the benzodiazepine receptor index during follow-up (mean 27±21 months) were negatively correlated with systolic blood pressure at follow-up. The relationship between changes in benzodiazepine receptor index and systolic blood pressure was different among patients with and without decreased cerebral blood flow at baseline (interaction, p<0.005). Larger increases in benzodiazepine receptor index (neuronal damage) were observed at lower systolic blood pressure levels in patients with decreased cerebral blood flow than in patients without such decreases.ConclusionIn patients without ischaemic stroke episodes at follow-up but with decreased cerebral blood flow due to arterial disease, low systolic blood pressure at follow-up may be associated with increased selective neuronal damage.