Cerebral autoregulation and vasomotor reactivity
Cerebral autoregulation and vasomotor reactivity
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DOI：
10.1159/000092434
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发表时间：
2006-01-01
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影响因子：
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通讯作者：
Aaslid, Rune
中科院分区：
文献类型：
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作者：
Aaslid, Rune
脑血流调节的各个方面可以通过经颅多普勒（TCD）进行评估。本章描述和讨论了文献中报告的方法。脑自动调节的稳态特性可以通过改变血压水平和计算血管运动的反应来确定。此外，可以在通过药理学手段降低血压后研究自动调节“平台期”的下限。TCD技术出色的时间分辨率还有助于确定自动调节反应的准静态和动态方面。腿袖法显示，调节作用非常快，在几秒钟内就能补偿血压的急剧下降。自动调节的特征可以通过记录血压的自发变化来评估，这一点不那么具有侵入性。传递函数方法描述了该机制的更快方面，而相关技术则揭示了准平稳特征。然而，基于自发波动的方法的可重复性和准确性可能低于刺激反应测试。在本章中，各种CO2和乙酰唑胺的方法，确定血管反应性进行了描述和讨论。
Various aspects of the cerebral blood-flow regulation can be assessed by transcranial Doppler (TCD). This chapter describes and discusses the approaches that have been reported in the literature. The steady-state characteristics of the cerebral autoregulation can be determined by changing the blood pressure level, and calculating the response of the vasomotors. Moreover, the lower limit of the autoregulatory ‘plateau’can be investigated after lowering the blood pressure by pharmacological means. The excellent time-resolution of the TCD technique also facilitates the determination of the quasi-stationary and dynamic aspects of the autoregulatory response. The leg-cuff method shows that regulatory action is very fast, compensating for a sharp drop in blood pressure within seconds. Less intrusively, the autoregulatory characteristics can be assessed from recordings of spontaneous variations in blood pressure. Transfer function methods describe the faster aspects of the mechanism, while correlation techniques reveal the quasi-stationary characteristics. However, the repeatability and accuracy of methods based on spontaneous fluctuations are probably less than those of stimulus–response tests. In this chapter, the various CO2 and acetazolamide approaches that determine vasomotor reactivity are described and discussed.