急性脑梗死患者脑氧代谢的初步研究  

Preliminary study of cerebral oxygen metabolism in the patients of acute cerebral infarction

作　　者：郑峥[1] 宿英英[1] 

机构地区：[1]首都医科大学宣武医院神经内科重症监护室,北京100053

出　　处：《中国脑血管病杂志》2005年第10期445-448,共4页Chinese Journal of Cerebrovascular Diseases

摘　　要：目的探讨急性脑梗死后脑氧代谢规律及其临床意义。方法将24例急性脑梗死患者按格拉斯哥昏迷评分(GCS)分成重症组(GCS≤8分)15例和非重症组(GCS>8分)9例。通过颈内静脉置管采血测定颈内静脉血氧饱和度(SjvO2),同时测量脉搏血氧饱和度(SpO2),并计算动脉颈静脉氧含量差(AVDO2)和脑氧摄取率,比较两组患者的SjvO2、AVDO2和脑氧摄取率,分析三者与GCS和格拉斯哥匹斯堡昏迷评分(GCSP)的相关性。结果重症组SjvO2为(76±6)%,非重症组为(69±4)%,脑氧摄取率重症组低于非重症组(P<0.05)。重症组多数患者为持续性SjvO2≥70%,而非重症组多为短暂性SjvO2≥70%。脑氧摄取率与GCS、GCSP呈显著正相关(P<0.05)。SjvO2≥70%患者的预后不良发生率显著高于SjvO2<70%的患者(P<0.05)。结论SjvO2能够客观反映急性脑梗死后脑氧代谢和脑血流状况,可作为评估预后的预测指标。Objective To investigate the changes of cerebral oxygen metabolism and their clinical value in acute cerebral infaretion. Methods Twenty four patients with acute cerebral infarction were assigned into severe group （ GCS≤8 ） and mild-moderate group （ GCS 〉 8 ） according to Glasgow Coma Scale（GCS） ,Blood samples were obtained via jugular vein catheter and oxygen saturation （ SjvO2 ） was measured. Simultaneously pulse blood oxygen saturations （ SpO2 ） was also measured. Arteriovenous oxygen content difference （AVDO2 ） and oxygen extraction fraction （OEF） were studied. These three parameters were compared between two the groups, and their correlation with GCS and GCS-P was analyzed. Results The SjvO2 in severe group was （76 ± 6）% , higher than that in mild-moderate group （69 ± 4） %, while the OEF in severe group was lower than that in mild-moderate group （ P 〈 0. 05）. The SjvO2 was persistently higher than 70% in most of severe patients, while temporarily higher in most mild-moderale patients. OEF was posilively correlated with GCS and GCS-P （ P 〈0. 05）. The possit）ilily of unfavourable prognosis in the patients with SjvO2≥70% was higher than those with SjvO2 〈70% （P 〈0.05） . Conclusion SjvO2 can refleel cerebral oxygen metabolism and cerebral blood flow objectively, and predict the prognosis of acute cerebral infarction.

关 键 词：氧 代谢 脑梗塞 血氧测定法 

分 类 号：R743.33[医药卫生—神经病学与精神病学]