体位性低血压患者的脑血流改变(附1例报告)  

Changes in cerebral blood flow in patient with orthostatic hypotension(report of one case)

作　　者：张津华 薛涵予 杨军华 李姻脂 ZHANG Jinhua;XUE Hanyu;YANG Junhua(Department of Rehabilitation,Kaifeng Central Hospital,Kaifeng 475000,Chino)

机构地区：[1]开封市中心医院康复医学科,475000 [2]武汉顾连康复医院 [3]河南大学临床医学院

出　　处：《临床神经病学杂志》2024年第3期213-216,共4页Journal of Clinical Neurology

基　　金：河南省医学科技攻关计划项目(LHGJ20200843)。

摘　　要：目的探讨1例颈髓损伤后无症状体位性低血压患者脑血流的自身调节机制。方法对患者进行直立倾斜实验,测量其肱动脉血压,使用TCD监测患者脑血流的参数变化,并计算脑血管阻力(CVR)。结果患者在平卧位时血压和右侧大脑中动脉收缩期峰流速(Vs)、舒张末期血流速度(Vd)、平均血流速度(Vm)、搏动指数(PI)及CVR均正常,倾斜30°、60°和90°时,血压、Vs、Vd、Vm和CVR均降低,PI均升高。结论颈髓损伤后无症状体位性低血压患者在出现体位性低血压时,脑血管收缩,脑血流减少。Objective To explore the autoregulation mechanism of cerebral blood flow in a patient with asymptomatic orthostatic hypotension after cervical spinal cord injury.Methods The patient underwent an upright tilt experiment to measure brachial artery blood pressure,cerebral blood flow parameters were monitored by TCD,and cerebral vascular resistance(CVR)was calculated.Results The data showed that the patient's blood pressure,right middle cerebral artery systolic peak flow velocity(Vs),end diastolic blood flow velocity(Vd),mean blood flow velocity(Vm),pulsatile index(PI),and CVR were normal in the supine position.However,when tilted at 30°,60°,and 90°,blood pressure,Vs,Vd,Vm,and CVR decreased,while PI increased.Conclusion When the patient with asymptomatic orthostatic hypotension after cervical spinal cord injury experiences with orthostatic hypotension,the cerebral vascular constricts and cerebral blood flow reduces.

关 键 词：体位性低血压 颈髓损伤 TCD 脑血管 自身调节 

分 类 号：R741[医药卫生—神经病学与精神病学]