超声评估模拟高原缺氧环境下脑血流自动调节功能的研究  

Study on Cerebral Autoregulation Under Simulated High-Altitude Hypoxic Environment by Ultrasound

作　　者：刘津津 范校周 桑亮[2] 游衍春 姚克纯 李玥铭 周玉彬 刘禧 Liu Jinjin;Fan Xiaozhou;Sang Liang;You Yanchun;Yao Kechun;Li Yueming;Zhou Yubin;Liu Xi(Air Force Medical Center,PLA,Beijing 100142,China;The First Hospital of China Medical University,Shenyang 110002,China)

机构地区：[1]中国人民解放军空军特色医学中心,北京市100142 [2]中国医科大学附属第一医院,沈阳市110002

出　　处：《中国超声医学杂志》2024年第6期601-604,共4页Chinese Journal of Ultrasound in Medicine

基　　金：空军装备科研项目(No.KJ2023C0KYD05);空军特色医学中心科技助推揭榜挂帅项目(No.2022ZTJB01);空军军医大学珠峰工程项目(No.2020ZFC001)。

摘　　要：目的 应用经颅多普勒超声联合逐搏血压监测探究高原预习服过程中在不同海拔阶梯式暴露过程中脑血流自动调节的变化。方法 以25名健康青年男性为研究对象,于低氧舱内分别模拟不同海拔高度(3 600 m、3 900 m、4 100 m、4 300 m)、不同缺氧时间(10 min内、1 h、2 h),测量单侧逐搏血压变化和大脑中动脉血流速度,计算0.02~0.07 Hz频段动态脑血流调节参数,并与平原海拔静息状态基础值比较,分析该频段相位差及增益变化情况。结果 与正常海拔时比较,极低频段各海拔缺氧2 h后相位差降低,增益升高(P<0.05)。模拟海拔3 600 m、3 900 m时,相位差及增益变化无统计学意义(P>0.05);模拟海拔4 100 m时,缺氧2 h较缺氧10 min增益上升(P<0.05);进入模拟4 300 m海拔缺氧1 h、2 h极低频段相位差降低(P<0.05)。结论 经颅多普勒超声联合逐搏血压监测可反映高原缺氧引起的脑调节功能参数变化。在预习服训练中海拔4 100 m及以上的高度应给予重点关注。Objective To investigate the changes of cerebral autoregulation in blood flow during hypoxia pre-adapting training on stepped exposures at different altitudes by using transcranial Doppler ultrasound combined with beat-to-beat blood pressure monitoring.Methods A total of 25 healthy male volunteers were enrolled in the study.The examination were performed in a hypoxic chamber,in which simulated different altitudes(3600 m,3900 m,4100 m,4300 m)and different hypoxic times(within 10 min,1 h,2 h).Unilateral beat-to-beat blood pressure changes and middle cerebral artery blood flow velocity were measured.The dynamic cerebral blood flow regulation pa-rameters in the frequency range of 0.02-0.07 Hz were calculated,and the basal values with those of plain altitude in resting state were compared and the phase difference and gain changes were analyzed.Results Compared with normal altitude,the phase difference decreases and the gain increases(P<0.05)after 2 h of hypoxia at various altitudes in the extremely low frequency range.At simulated altitudes of 3600 m and 3900 m,there was no significant difference in phase difference and gain(P>0.05).At the simulated 4100 m,the gain of hypoxia for 2 h increased compared with that of 10 min(P<0.05);the phase difference of the very-low-frequency band decreased when we entered the simulated 4300 m altitude for 1 h and 2 h(P<0.05).Conclusions Transcranial Doppler ultrasound combined with beat-to-beat blood pressure monitoring can reflect the changes of cerebral autoregulation parameters caused by high-al-titude hypoxia.Altitude of 4100 meters or above should be given attention as an important indicator in hypoxia pre-a-dapting training and hypoxic tolerance evaluation.

关 键 词：超声 经颅多普勒 脑血流自动调节 缺氧 预习服 

分 类 号：R445.1[医药卫生—影像医学与核医学] R594.3[医药卫生—诊断学]