CAJ | 학술논문

目的研究经颅多普勒（TCD）在脑血流自动调节下限检测中的应用，拓宽TCD的应用范围。方法利用TCD检测SD大鼠大脑中动脉（MCA）的血流速度，同步记录有创血压，按照临界关闭压（CCP）的理论测定脑血流自动调节下限，与常用的缓慢放血降低血压，绘制脑血流自动调节曲线法测定的自动调节下限进行比较。结果缓慢放血降低血压过程中，MCA的血流速度和颈总动脉的血流量下降趋势完全一致(r=0.951 16±0.057 36,P<0.001)，可以用MCA的血流速度代替血流量计算CCP。 CCP法检测到的脑血流自动调节下限为（70.88±24.05）mm Hg（1 mm Hg=0.133 kPa），与放血降低血压利用血流速度和血流量变化测定的结果［分别为（72.88±26.26）mm Hg和（75.63±22.22）mm Hg］高度相关（r分别为 0.794 55 和 0.738 46，P均<0.001），数值相近，来源于同一群体（P分别为 0.967 58 和 0.817 68），前者可以代替后两者。结论 TCD检测MCA的血流速度，同步记录动脉血压，按照CCP理论测定脑血流自动调节下限，切实可行，结果可靠，可以准确、快捷地反映脑血流动力学变化。
목적연구경로다보륵（TCD）재뇌혈류자동조절하한검측중적응용，탁관TCD적응용범위。방법이용TCD검측SD대서대뇌중동맥（MCA）적혈류속도，동보기록유창혈압，안조림계관폐압（CCP）적이론측정뇌혈류자동조절하한，여상용적완만방혈강저혈압，회제뇌혈류자동조절곡선법측정적자동조절하한진행비교。결과완만방혈강저혈압과정중，MCA적혈류속도화경총동맥적혈류량하강추세완전일치(r=0.951 16±0.057 36,P<0.001)，가이용MCA적혈류속도대체혈류량계산CCP。 CCP법검측도적뇌혈류자동조절하한위（70.88±24.05）mm Hg（1 mm Hg=0.133 kPa），여방혈강저혈압이용혈류속도화혈류량변화측정적결과［분별위（72.88±26.26）mm Hg화（75.63±22.22）mm Hg］고도상관（r분별위 0.794 55 화 0.738 46，P균<0.001），수치상근，래원우동일군체（P분별위 0.967 58 화 0.817 68），전자가이대체후량자。결론 TCD검측MCA적혈류속도，동보기록동맥혈압，안조CCP이론측정뇌혈류자동조절하한，절실가행，결과가고，가이준학、쾌첩지반영뇌혈류동역학변화。
Objective　To study a new usage of transcranial Doppler (TCD) to assess the lower limit of cerebral blood flow autoregulation and widen the field of TCD.Methods　The blood velocities of MCA were probed by transcranial Doppler in SD rat, and femoral blood pressure was recorded simultaneously by physiological multimeter. Then lower limit of cerebral blood flow autoregulation was figured out by the clinical closing pressure (CCP) and compared with the results obtainea by hemorrhage hypotension.Results　In the process of hemorrhage hypotension, both of the velocity of MCA and the blood quality of common carotid artery were reduced, and the decreasing rate of velocity was almost equal to the one of blood quality (r=0.951 16±0.057 36,P<0.001). So the velocity of MCA probed by TCD could replace the blood quality to calculate CCP. The lower limit of autoregulation of normal SD rats working out by CCP was (70.88±24.05)mm Hg(1 mm Hg=0.133 kPa). It highly correlated to the results measured by hemorrhage hypotension ［velocity of MCA:(72.88±26.26)mm Hg and quality of CCA:(75.63±22.22)mm Hg］. The latter should be replaced by the former.Conclusions　The cerebral blood flow can be evaluated conveniently and exactly by lower limit of autoregulation figured out from MCA velocities and arterial blood pressure recorded simultaneously.