自主神经兴奋性在不同部位脑梗死时对脑血流动力学的影响  

Influence of autonomic excitability on cerebral hemodynamics in patients with cerebral infarction in different positions

作　　者：元小冬[1] 张萍淑[1] 陈静[2] 葛秀凤[1] 裴唤珍[1] 马英[1] 

机构地区：[1]华北煤炭医学院附属开滦医院神经内科,唐山063000 [2]华北煤炭医学院基础部

出　　处：《华北煤炭医学院学报》2001年第2期133-135,共3页Journal of North China Coal Medical College

摘　　要：1目的　研究不同部位脑梗死时自主神经兴奋性对脑血流动力学的影响。 2方法　不同部位脑梗死患者和健康查体人员共 96例 ,并在左耳给予 30℃水 5 0 ml刺激前庭诱发其自主神经反应 ,于刺激前、后分别测定颅内 9条主要脑血管的血流动力学指标。3结果　刺激前、后测定的各脑血管血流动力学指标均无明显变化 (P>0 .0 5 ) ,对脑梗死部位与刺激前、后脑血流动力学指标 ,右大脑前动脉收缩峰速度、年龄、刺激前左大脑后动脉舒张末速度、刺激后右大脑前动脉舒张末速度 4项有明显相关性 (P<0 .0 5 ) ;对刺激后无眩晕组与刺激前左大脑前动脉舒张末速度 3项呈相关性 (P<0 .0 5 ) ;而刺激后出现眩晕组则筛选出刺激后右大脑前动脉收缩峰速度、刺激后右侧椎动脉收缩峰速度及右侧椎动脉舒张末速度、和刺激前右大脑中动脉收缩峰速度等 4项指标显著相关 (P<0 .0 5 )。 4结论　脑血管对于自主神经兴奋性的改变具有很好的协调功能 ,但若病灶影响了右大脑前动脉血流收缩峰速度和舒张末速度、左椎动脉血流舒张末速度和右椎动脉的收缩峰速度可能较易并发应激性自主神经反应 ;左大脑前动脉舒张末速度和右椎动脉的收缩峰速度可能较易并发应激性自主神经反应 ;左大脑前动脉舒张末速度、左大脑后动脉血流舒张末速度较高时 。Objective To study the influence of autonomic excitability on cerebral hemodynamics in patients with cerebral infarction in different position.Methods 96 patients with cerebral infarction in different position and health persons were induced autonomic never reaction under vestibular stimulus with 50 ml and 30℃ water in left ear,9 cerebralvascular hemodynamics indices were examined before and after stimulus.Results 9 cerebrovascular hemodynamics indices were not changed before and after stimulus,it showed that there were markedly relations of infarctional site to hemodynamic indiced the peak systolic velocity of right anterior cerebral artery after vestibular stimulus,age,the enddiastolic flow velocity in left posterior cerebral artery before vestibular stimulus,the enddiastolic flow velocity in right posterior cerebral artery after vestibular stimulus had distinctness relativity.It was found that sex,age and the enddiastolic flow velocity in left anterior cerebral artery before vestibular stimulus are related to 3 indices in non giddy growp(P<0.05).The peak systolic velocity in right anterior cerebral artery,the peak systolic velocity in right anterior cerebral artery,the peak systolic velocity in right vertebral artery and the enddiastolic flow velocity in left vertebral artery after stimulus,the peak systolic velocity in right middle cerebral artery before and after vestibular stimulus are related to 4 indices in giddy group(P<0.05).Conclusion Cerebrovascular has good function of interc ede to change of autonomic excitability.Irritable reaction will occur easily if focus impact the peak systolic velocity and the enddiastolic flow velocity in right anterior cerebral artery,the enddiastolic flow velocity in left vertebral artery,the peak systolic velocity in right vertebral artery.Irritable damage reaction may be avoided when the enddiastolic flow velocity in left anterior cerebral artery and left posterior cerebral artery are greater. [

关 键 词：脑梗死 前庭刺激 自主神经兴备性 血流动力学 

分 类 号：R743.31[医药卫生—神经病学与精神病学]