| 齐猛，王宁，程玮涛，蒋丽丹，陈文劲，曲鑫，徐跃峤.超声评估远隔缺血适应对动脉瘤性蛛网膜下腔出血患者脑血流的影响[J].神经损伤功能重建,2021,16(2):76-78 |
| 超声评估远隔缺血适应对动脉瘤性蛛网膜下腔出血患者脑血流的影响 |
| Effect of Remote Ischemic Conditioning on Cerebral Blood Flow Evaluated by TranscranialDoppler in Patients with Aneurysmal Subarachnoid Hemorrhage |
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| DOI： |
| 中文关键词: 颅内动脉瘤；蛛网膜下腔出血 远隔缺血适应；经颅超声多普勒；脑血流 |
| 英文关键词: intracranial aneurysm subarachnoid hemorrhage remote ischemic conditioning transcranial doppler cerebral blood flow |
| 基金项目:北京市科技计划
首都临床特色应
用研究与成果推
广（No. Z15110000
4015095）；
北京市215高层次
卫生技术人才学
术 骨 干 项 目（No.
2015-3-092）；
首都医科大学宣
武医院基础临床
研究项目（No. X
WYY201709） |
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| 中文摘要: |
| 目的：探讨远隔缺血适应（RIC）对动脉瘤性蛛网膜下腔出血（aSAH）患者脑血流的影响。方法：选择
2017 年11月至2018 年5月首都医科大学宣武医院神经外科重症监护病房连续收治的aSAH患者24例，所
有患者在aSAH后72 h内接受动脉瘤夹闭和栓塞治疗，术后7 d内进行RIC干预5次。在RIC干预前、后采
用经颅超声多普勒（TCD）评估脑血流，包括前循环：双侧大脑前动脉（ACA）、双侧大脑中动脉（MCA）、同侧
MCA/颈内动脉（ICA）终末段血流速度比值（ratio）；后循环：双侧大脑后动脉（PCA）、双侧椎动脉颅内段
（VA）、基底动脉（BA）。RIC干预结束后复查头颅CT或MRI，判断有无新发梗死。结果：RIC干预后，患者
前循环血流R-MCA、L-ACA及R-ratio较干预前升高（均P＜0.05），升高幅度均＜20%，其余参数差异无统计
学意义（均P＞0.05）。RIC干预后，患者后循环血流L-VA及BA较干预前升高（均P＜0.05），升高幅度均＜
20%，其余参数差异无统计学意义（均P＞0.05）。RIC干预结束后，CT或MRI均未发现新发脑梗死。结论：
RIC干预在aSAH应用中对脑血流影响不明显，未导致新发脑梗死，其安全性得到初步证实。 |
| 英文摘要: |
| To explore the effect of remote ischemic conditioning (RIC) on cerebral blood flow in patients with aneurysmal subarachnoid hemorrhage (aSAH). Methods: Included in this study were 24 aSAH patients consecutively admitted to the Intensive Care Unit of the Department of Neurosurgery at Xuanwu Hospital
from November 2017 to May 2018. All patients underwent aneurysm clipping and embolization treatment within
72 hours of aSAH and received RIC 5 times within 7 days after treatment. Before and after RIC intervention,
transcranial doppler (TCD) was used to evaluate cerebral blood flow in the anterior circulation, including that of
the bilateral anterior cerebral arteries (ACA), bilateral middle cerebral arteries (MCA), and the ipsilateral MCA/
internal carotid artery (ICA) terminal section flow velocity ratio (ratio). The posterior circulation blood flow was
also evaluated, including that at the bilateral posterior cerebral arteries (PCA), bilateral vertebral arteries (VA),
and basilar artery (BA). Head CT or MRI recheck was performed after RIC intervention to evaluate the fresh infarctions. Results: Compared to data before RIC intervention, cerebral blood flow after intervention at the
R-MCA, L-ACA, and R-ratio of the anterior circulation were increased (all P<0.05), with this increase being less
than 20% , and the remaining parameters showed no significant difference (P>0.05). After RIC intervention,
blood flow at the L-VA and BA of the posterior circulation were increased compared to those before intervention
(all P0.05). Neither CT nor MRI showed fresh cerebral infarction after RIC intervention. Conclusion: RIC had no
obvious effect on cerebral blood flow in patients with aneurysmal subarachnoid hemorrhage and did not trigger
fresh cerebral infarctions. This study confirms the preliminary safety of RIC. |
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