卒中後遺症に於ける腦循環及び代謝の研究
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概要
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The cerebral circulation and metabolism were determined by the modification of Kety & Schmidts nitrous oxide method in 30 case with hemiplegia by the cerebral vascular accidents and one case of apoplectic stroke. In the hemiplegic patients as the results of significantly increased cerebral vascular resistance (CVR) apparently decreased cerebral blood flow (CBF), cerebral oxygen delivery (CDo2) and reduced cerebral oxygen consumption (CMRo2) were observed.By the increased cerebral oxygen extraction ratio (CERo2) the diminution of CMRo2 was lesser than the reduction of CDo2. There was no significantly change in cerebral respiratory quotient (CRQ).In the case of apoplectic stroke a diminution of CMRo2 and CERo2 were observed. In the essential hypertension a increase of CVR was a only change, but when the cerebral arteriosclerosis accompanied with it, CBF and CMRo2 were slightly decreased.In the cerebral arteriosklerosis one case showed no much change, but the another one proved the decreas of CBF and CMRo2 according to the increased CVR.In the patients of hemiplegia we observed the relationship between cerebral hemodynamics and the existence of mental changes, the duration after the stroke, the findings of retinae, age and the rehabilitation. However there was no relationship between them.We assumed that in these cases the changes of cerebral hemodynamics were more based on the advanced cerebral arteriosclerosis or in addition hypertension than the local damage of the brain.We calculated the cerebral vascular reactivity following the changes of CVR after 5% carbon dioxide inhalation.Though in the patients of hemiplegia with hypertension were observed some reactivity, it was very much diminished. We measured the effects of papaverin hydrochloride, priscol, aminophyllin and stellateganglion block on the cerebral circulation and then we concluded the methods which let the abnormality of cerebral circulation and metabolism return to normal, is effecient as the therapeutic means.
- 社団法人 日本内科学会の論文