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Brain and Nerve No to Shinkei Volume 42, Issue 2 （February 1990）

Brain and Nerve 脳と神経 42巻2号（1990年2月発行）

Japanese English

原著

頭蓋内圧上昇時の脳微小循環—reflectance photometry法を用いた検討 CEREBRAL MICROCIRCULATION DURING INCREASED INTRACRANIAL PRESSURE : ASSESSMENT WITH REFLECTANCE PHOTOMETRY 橋本研二 ¹ , 菊池晴彦 ¹ , 石川正恒 ¹ , 絹田祐司 ¹ , 秋山義典 ¹ Kenji Hashimoto ¹ , Haruhiko Kikuchi ¹ , Masatsune Ishikawa ¹ , Yuji Kinuta ¹ , Yoshinori Akiyama ¹ ¹京都大学医学部脳神経外科 ¹Department of Neurosurgery, Faculty of Medicine, Kyoto University キーワード： increased intra-cranial pressure , cerebral blood flow , hemoglobin oxygenation , tissue hemoglobin Keyword: increased intra-cranial pressure , cerebral blood flow , hemoglobin oxygenation , tissue hemoglobin pp.153-158

発行日 1990年2月1日 Published Date 1990/2/1

DOI https://doi.org/10.11477/mf.1406900017

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Abstract 文献概要
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　頭蓋内圧上昇時における脳微小循環を解明するためreflectance photometry法を用い検討した。まず本法により得られる組織ヘモグロビン量および組織酸素飽和度を脳内ヘモグロビン量，上矢状洞内血液酸素飽和度との相関を確かめたが両者はいずれも高い相関を示しており脳組織においても適用可能な方法と考えられた。続いて成猫を用い，大槽よりの人工髄液注入による頭蓋内圧上昇モデルを作成し，脳血流量，組織酸素飽和度，組織ヘモグロビン量を測定した。脳漕流圧40mmHg以下において脳血流量の低下を認め，同時期より組織酸素飽和度の減少を認めた。脳灌流圧低下にもかかわらず脳血流量が保たれている状態においては組織ヘモグロビン量の増加は認められなかった。組織酸素飽和度は組織の酸素摂取率を反映するものと考えられ，脳血流量と脳酸素代謝の両方を示す指標として各種病態において連続モニターとして有用と思われた。

The cerebral microcirculation under increased intracranial pressure was evaluated by using re-flectance photometric method. The values of tissue hemoglobin (IHb) and its oxygen saturation (ISO₂) detected by this method were evaluated in cat brain tissue. The correlation between IHb and conent of cortical hemoglobin subunits in vitro was high. High correlation between ISO₂ and blood oxygen saturation in superior sagittal sinus was also noted in hypoxic hypoxia. Thus, the reflectance photometric method was revealed to be applicable for evaluation of regional hemo-globin content and oxygen saturation. Using this method the cerebral microcirculation was studied in an increased intracranial pressure model pro-duced by injection of artificial CSF into the cis-terna magna in cats. Regional cortical cerebral blood flow (CBF) was measured simultaneously by thermal diffusion method. During decrease of per-fusion pressure down to 40 mmHg with preservation of CBF, compensatory increase of IHb was not observed, but IHb rather gradually decreased. The decrease of IHb would be due collapse of capacitance vessels by increased intracranial pres-sure. Cerebral ISO₂ was stable as well as CBF. Less than 40 mmHg of perfusion pressure, ISO₂ started to decrease in association with CBF and IHb. Since ISO₂ seems to be closely related tothe tissue oxygen extraction the change of ISO₂ reflect the CBF and tissue cerebral oxygen meta-bolism. Present study suggest the evaluations ofIHb and ISO₂ were an useful monitoring indexes in various cerebral disorders.