脑血流自动调节监测在脑血管疾病中的临床应用

摘要

脑血流自动调节(cerebral autoregulation,CA)是指脑血流在动脉血压(arterial blood pressure,ABP)和脑灌注压(cerebral perfusion pressure,CPP)发生改变时保持相对稳定的能力。临床主要通过改变血压后测量脑血流的变化以反映CA的方式很多,常用的有：下肢负压、冷加压试验、Valsalva动作等。通过改变脑灌注压来评估CA能力主要由经颅多普勒超声(transcranial Doppler,TCD)来实现,它是在生理和病理情况下测定脑血流速度和CA的有效工具,它结合体位改变对脑血流进行测量是一种更方便、更易接受的方法,对缺血性脑血管病的预后评估起到重要作用。本文就CA监测在脑血管疾病中的临床应用做一综述。%Cerebral autoregulation(CA) is the mechanism by which constant cerebral blood flow is maintained despite changes in arterial blood pressure and cerebral perfusion pressure. The main ways to measure the stability of the cerebral blood flow by changing the blood pressure to evaluate the CA are lower body negative pressure, cold pressor test, Valsalva maneuver and so on. By changing cerebral perfusion pressure to assess CA, we use transcranial Doppler(TCD). It is an efficient tool to measure cerebral blood velocities and CA under physiological states and pathological conditions, and it is a more convenient and acceptable method when combined with postural changes to measure cerebral blood velocities, and plays an important role in evaluating the prognosis of ischemic cerebrovascular disease. This article mainly reviews CA monitoring in cerebrovascular diseases.