动脉血PaCO_2对慢性缺血性脑血管病的意义
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摘要
目的探讨PaCO2对于慢性缺血性脑血管病的意义。方法回顾武警总医院神经外科2015-01—2016-12慢性缺血性脑血管病患者80例及同时期不伴有脑血管病人51例,血气分析仪器均采用全自动血气分析仪,利用t检验对动脉血PaCO2进行对照分析。结果慢性缺血性脑血管病患者动脉血PaCO2较正常人水平高(P<0.05),同时此类患者术后PaCO2较术前明显降低(P<0.05)。结论动脉血PaCO2对于慢性缺血性脑血管病的诊断及疗效评估均有参考价值。
Objective To discuss the significance of partial pressure of carbon dioxide to patients with chronic ischemic cerebrovascular disease.Methods We reviewed the patients with chronic ischemic cerebrovascular disease treated by surgical operation(80 cases)and people without chronic ischemic cerebrovascular disease(51 cases)admitted in neurosurgery of Chinese Armed Police General Hospital from January to December in 2016.We collected the partial pressure of carbon dioxide of the subjects by fully automatic blood gas analyzer,then compared the difference of partial pressure of carbon dioxide between normal people and patients with chronic ischemic cerebrovascular disease.We analyzed the preoperative and postoperative partial pressure of carbon dioxide of these patients.Results The carbon dioxide levels of patients with chronic ischemic cerebrovascular disease were higher(P<0.05)than normal persons,while the postoperative carbon dioxide levels were significantly decreased(P<0.05).Conclusion Partial pressure of carbon dioxide has reference value for the diagnosis and curative effect evaluation of chronic ischemic cerebrovascular disease.
Objective To discuss the significance of partial pressure of carbon dioxide to patients with chronic ischemic cerebrovascular disease.Methods We reviewed the patients with chronic ischemic cerebrovascular disease treated by surgical operation(80 cases)and people without chronic ischemic cerebrovascular disease(51 cases)admitted in neurosurgery of Chinese Armed Police General Hospital from January to December in 2016.We collected the partial pressure of carbon dioxide of the subjects by fully automatic blood gas analyzer,then compared the difference of partial pressure of carbon dioxide between normal people and patients with chronic ischemic cerebrovascular disease.We analyzed the preoperative and postoperative partial pressure of carbon dioxide of these patients.Results The carbon dioxide levels of patients with chronic ischemic cerebrovascular disease were higher(P<0.05)than normal persons,while the postoperative carbon dioxide levels were significantly decreased(P<0.05).Conclusion Partial pressure of carbon dioxide has reference value for the diagnosis and curative effect evaluation of chronic ischemic cerebrovascular disease.
引文
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[2]SATO K,SADAMOTO T,HIRASAWA A,et al.Differential blood flow responses to CO2 in human internal and external carotid and vertebral arteries[J].J Physiol,2012,590(14):3 277-3 290.
[3]张春娣.CO2分压与脑血流的关系文献回顾[J].齐齐哈尔医学院学报,2014,35(11):1 656-1 657.
[4]AINSLIE P N,ASHMEAD J C,IDE K,et al.Differential responses to CO2 and sympathetic stimulation in the cerebral and femoral circulations in humans[J].J Physiol,2005,566(2):613-624.
[5]HGERDAL M,J R H,BO K S.Influence of Changes in Arterial P CO2,on Cerebral Blood Flow and Cerebral Energy State during Hypothermia in the Rat[J].Acta Anaesthesiol Scand Suppl,1975,19(Supplement s57):25-33.
[6]ATKINSON J L,ANDERSON R E,JR S T.The effect of carbon dioxide on the diameter of brain capillaries[J].Brain Research,1990,517(1-2):333-340.
[7]BUSIJA D W,HEISTAD D D.Factors involved in the physiological regulation of the cerebral circulation[J].Rev Physiol Biochem Pharmacol,1984,101(1):161.
[8]WEI E P,KONTOS H A,Jr P J.Dependence of pial arteriolar response to hypercapnia on vessel size[J].Am J Physiol,1980,238(5):697.
[9]NELSON M T,QUAYLE J M.Physiological roles and proper-ties of potassium channels in arterial smooth muscle[J].Am J Physiol,1995,268(1):799-822.
[10]KINOSHITA H,KATUSIC Z S.Role of potassium channels in relaxations of isolated canine basilar arteries to acidosis[J].Stroke,1997,28(2):433.
[11]XU H,CUI N,YANG Z,et al.Direct activation of cloned K(atp)channels by intracellular acidosis[J].J Biol Chem,2001,276(16):12 898-12 902.
[12]ORRISS I R,KEY M L,HAJJAWI M O,et al.Extracellular ATP released by osteoblasts is a key local inhibitor of bone mineralisation[J].Plos One,2013,8(7):e69057.
[13]BRAYDEN J E,NELSON M T.Regulation of arterial tone by activation of calcium-dependent potassium channels[J].Science,1992,256(5 056):532.
[14]COLEMAN H A,TARE M,PARKINGTON H C.Endothelial potassium channels,endothelium-dependent hyperpolarization and the regulation of vascular tone in health and disease[J].Clin Exp Pharmacol Physiol,2004,31(9):641-649.
[15]LEDOUX J,WERNER M E,BRAYDEN J E,et al.Calcium-activated potassium channels and the regula-tion of vascular tone[J].Physiology,2006,21(1):69.
[16]JACKSON W F.Potassium Channels in the Peripheral Microcirculation[J].Microcirculation,2005,12(1):113-127.
[17]NIKOLI D,BIRCH A A,PANERAI R B,et al.Assessing cerebral blood flow control from variability in blood pressure and arterial CO2levels[J].Conf Proc IEEE Eng Med Biol Soc,2015,2015:1 785-1 788.
[18]SERRADOR J M,HUGHSON R L,KOWALCHUK J M,et al.Cerebral blood flow during orthostasis:role of arterial CO2[J].Am J Physiol Regul Integr Comp Physiol,2006,290(4):R1 087.
[19]BATTISTI-CHARBONNEY A,FISHER J,DUFFIN J.The cerebrovascular response to carbon dioxide in humans[J].J Physiol,2011,589(12):3 039-3 048.
[20]GRNE F,KAZMAIER S,STOLKER R J,et al.Carbon dioxide induced changes in cerebral blood flow and flow velocity:role of cerebrovascular resistance and effective cerebral perfusion pressure[J].J Cereb Blood Flow Metab,2015,35(9):1 470.