Effect of liver failure on the cerebral circulatory and metabolic responses to hypoxia in the goat.

1. Six unanaesthetized goats were used to evaluate the effect of liver failure on the hypoxic responsiveness of cerebral blood flow. The animals breathed air and several different hypoxic gas mixtures enriched with sufficient CO2 to maintain an isocapnic state. The cerebral metabolic rate for O2 (CMRo2) was also measured in four of these goats. 2. In baseline studies there was a linear relationship between cerebral blood flow and arterial O2 saturation (Sa,o2) measured at different levels of isocapnic hypoxia. The slopes of the cerebral blood flow/Sa,o2 response lines were used to quantify the response of cerebral blood flow to hypoxia. In the healthy goat, CMRo2 was not depressed by hypoxia until the O2 tension (Po2) in arterial and cerebral venous blood had fallen below critical threshold values of approximately 3-2 and 2-2 kPa (24 and 16 mmHg) respectively. 3. Liver failure was accompanied by a fall in cerebral blood flow and CMRo2. There was also a depression in the response of cerebral blood flow to hypoxia and a disproportionate reduction of cerebral O2 delivery in hypoxia. CMRo2 was further reduced at arterial and cerebral venous Po2 values, which were much higher than the critical threshold values for producing hypoxic CMRo2 depression in health. 4. It is concluded that the brain becomes more vulnerable to the adverse effects of hypoxia during liver failure. This may be of practical importance in the management of patients with arterial hypoxaemia or other complications (e.g. anaemia or shock), which may reduce cerebral oxygen delivery.     

氦氖激光血管内照射对脑动脉硬化患者血浆D—二聚体等的影响

目的：进一步探讨低能量氦氖激光血管内照射（ＩＬＩＢ）对脑动脉硬化患者的治疗机制，观察治疗前后血浆Ｄ－二聚体（Ｄ－Ｄ）、过氧化脂质（ＬＰＯ）、超氧化物歧化酶（ＳＯＤ）及主要临床症状变化。方法：对４０例脑动脉硬化患者选择肘正中静脉采用ＩＬＩＢ疗法，功率２．５ｍＷ／ｃｍ２照射６０分钟，每日１次，１０次为１疗程。于治疗前和疗程后采空腹静脉血测定上述指标并进行ｔ检验。结果：治疗后血浆Ｄ－Ｄ和ＬＰＯ值下降，ＳＯＤ值上升，主要临床症状改善。结论：ＩＬＩＢ可降低血液高凝状态，提高机体抗氧化机能，减轻自由基对机体的损伤。     

阿托伐他汀对老年脑梗死伴高血脂患者颈动脉粥样硬化斑块的影响

目的探讨阿托伐他汀的降脂疗效及对老年脑梗死伴高血脂患者颈动脉粥样硬化斑块的影响。方法采取治疗前后自身对照比较的方法,选择50例脑梗死合并颈动脉粥样硬化斑块患者,给予阿托伐他汀10mg,qn总疗程1年,分别测定治疗前及治疗后6～12个月的血脂、颈动脉内膜-中层厚度、颈动脉斑块面积的变化。结果阿托伐他汀治疗6～12个月后,TC、LDL-C、TG降低（P〈0．05）,HDL-C升高（P〈0．01）;颈动脉的内径有所扩大,颈动脉斑块缩小,尤以12个月后改变显著（P〈0．01）。结论阿托伐他汀降脂疗效确切,减少并稳定斑块的作用。     

阿托伐他汀对老年脑梗死伴高血脂患者颈动脉粥样硬化斑块的影响

Objective To investigate the effect of atorvastatin on arteriosclerosis plaque of carotid artery in elder patients with cerebral infarction and hypercholesterolemia. Methods With self-comparsion of before and after treatment,50 subjects with arteriosclerosis plaque of carotid artery were given atorvastatin 10 mg,qn for 12 months. After treatment 6 and 12 months, arteriosclerosis plaque of carotid artery、 intima-media thickness and peak index were measured in all patients. Results After 6 and 12 months adminstration of atorvastatin, TC、TG、LDL-C were all reduced (P<0.05), and HDL-C was elevated (P<0.01) in all patients.The initial diameter of carotid was significantly enlarged in 12 months (P<0.01). The size of plaque decreased (P<0.01) in 12 months after atorvastatin therapy than before(P<0.01). Conclusion The effect of atorvastatin is certain and it can stabilize the plaque of carotid artery.     

阿托伐他汀对老年脑梗死伴高血脂患者颈动脉粥样硬化斑块的影响

Objective To investigate the effect of atorvastatin on arteriosclerosis plaque of carotid artery in elder patients with cerebral infarction and hypercholesterolemia. Methods With self-comparsion of before and after treatment,50 subjects with arteriosclerosis plaque of carotid artery were given atorvastatin 10 mg,qn for 12 months. After treatment 6 and 12 months, arteriosclerosis plaque of carotid artery、 intima-media thickness and peak index were measured in all patients. Results After 6 and 12 months adminstration of atorvastatin, TC、TG、LDL-C were all reduced (P<0.05), and HDL-C was elevated (P<0.01) in all patients.The initial diameter of carotid was significantly enlarged in 12 months (P<0.01). The size of plaque decreased (P<0.01) in 12 months after atorvastatin therapy than before(P<0.01). Conclusion The effect of atorvastatin is certain and it can stabilize the plaque of carotid artery.     

120例脑梗死患者颈动脉硬化状况分析

目的探讨急性脑梗死患者颈动脉粥样硬化的发病情况及与急性脑梗死的关系。方法对120例急性脑梗死患者采用美国ATL-3000彩色多普勒超声诊断仪行颈动脉超声检测,并对其有无动脉粥样斑块和狭窄及阻力指数进行评估和分析。结果急性脑梗死患者颈动脉粥样斑块的发生率为82.5%,颈动脉狭窄的发生率为7.5%.97例高血压患者中检出颈动脉病变66例,检出率68%;49例血脂异常患者中检出颈动脉病变23例,检出率47%;14例糖尿病患者中检出颈动脉病变5例,检出率36%。结论颈动脉粥样硬化与脑梗死有密切的相关性。超声检查能早期发现颈动脉粥样硬化,对有效预防脑梗死的发生有重要意义。     

Place of vasoactive agents in the treatment of acute circulatory failure

Increase in total cardiac output can improve oxygen delivery to the cells. Although inotropic drugs increase primarily myocardial contractility, they can adversely affect cardiac preload and afterload. Moreover, they can dangerously increase myocardial oxygen requirements. The combined use of vasodilating agents, with fluid challenge represents a challenging but more efficient treatment of acute circulatory failure.