急进高原的健康人群脑血管反应性研究  

Cerebrovascular Reactivity Changes in Healthy Adults Rapidly Ascending to High Altitude

作　　者：高雁青[1] 张淑坤[2] 吴世政[2] 

机构地区：[1]青海大学医学院,西宁810000 [2]青海省人民医院

出　　处：《中国卒中杂志》2013年第6期449-453,共5页Chinese Journal of Stroke

摘　　要：目的探讨健康成年人急进高原低压、低氧环境后脑血管反应性(cerebrovascular reactivity,CVR)的变化及其可能机制。方法采用经颅多普勒超声监测仪评估健康成年人从海拔2200m急进到海拔3800m前后CVR;用硝酸还原酶法测定该组研究人群血浆一氧化氮(nitric oxide,NO)水平,采用酶联免疫吸附法测定其血浆内皮型一氧化氮合酶(endothelial nitric oxide synthase,eNOs)水平。结果研究人群共46例,急进高原后较急进高原前CVR增高,差异有显著性[CVR:2.36±0.74 vs 1.43±0.46,P<0.001;CVR指数(cerebrovascular reserve index,CVRI):2.56±0.89 vs 1.82±0.71,P<0.001];血浆NO水平升高,差异有显著性[(44.97±0.68)μmol/L vs(34.45±2.86)μmol/L,P<0.001];血浆eNOS水平升高,差异有显著性[(274.81±13.68)pg/mlvs(209.73±14.34)pg/ml,P<0.001];急进高原后较急进高原前正常呼吸时双侧大脑中动脉平均脑血流速度明显升高,差异有显著性[(93.78⊥11.67)cm/svs(80.85_11.14)cm/s,P<0.001]。结论健康成年人急进高原后,CVR、血浆NO及eNOS含量和大脑中动脉平均脑血流速度都明显升高,以适应急进海拔3800m后的脑缺氧情况。Objective To investigate the cerebrovascular reactivity （CVR） changes of healthy individuals after rapidly ascending to high altitude and its underlying mechanisms. Methods CVR of healthy adults who rapidly ascended from 2200 meters above the sea level to 3800 meters was evaluated by transcranial Doppler ultrasound;The plasma level of nitric oxide （NO） was determined by nitrate reduction method;The plasma level of endothelial nitric oxide synthase （eNOS） was determined by enzyme linked immune absorption methods.Results A total of 46 cases were analyzed in our present study. CVR was significantly increased after rapidly ascending to high altitude than before （before ascending to high altitude CVR 1.43±0.46, cerebrovascular reserve index [CVRI] 1.82±0.71; after rapidly ascending to high altitude CVR 2.36±0.74, CVRI 2.56±0.89, P〈0.001）; Plasmic NO （μmol/L） and eNOS （pg/ml） were significantly increased after rapidly ascending to high altitude than before （before ascending to high altitude NO 34.45±2.86, eNOS 209.73±14.34;after rapidly ascending to high altitude NO 44.97±0.68, eNOS 274.81±13.68, P〈0.001）;Mean cerebral blood flow velocity of bilateral middle cerebral artery （MCAv） （cm/s） was significantly increased during regular breathing after rapidly ascending to high altitude than before （before ascending to high altitude MCAv 80.85±11.14, after ascending to high altitude MCAv 93.78±11.67, P〈0.001）. Conclusion Our study reveals that CVR, plasmic NO, eNOS, and MCAv in healthy adults are increased after they rapidly ascend to high altitude, which are adaptive strategies of brain in high altitude hypoxic environment.

关 键 词：急进高原 脑血管反应性 一氧化氮 内皮型一氧化氮合酶 

分 类 号：R743.3[医药卫生—神经病学与精神病学]