PDF(Pubmed)
Abstract：
UNASSIGNED: This study aimed to directly measure cerebrospinal fluid (CSF) gas tensions and pH before and after superficial temporal artery to middle cerebral artery (STA-MCA) anastomosis for moyamoya disease.
UNASSIGNED: This study included 25 patients with moyamoya disease who underwent STA-MCA anastomosis combined with indirect bypass onto their 34 hemispheres. About 1 mL of CSF was collected before and after bypass procedures to measure CSF partial pressure of oxygen (PCSFO2), CSF partial pressure of carbon dioxide (PCSFCO2), and CSF pH with a blood gas analyzer. As the controls, the CSF was collected from 6 patients during surgery for an unruptured cerebral aneurysm. PCSFO2 and PCSFCO2 were expressed as the ratio to partial pressure of oxygen (PaO2) and partial pressure of carbon dioxide (PaCO2), respectively.
UNASSIGNED: PCSFO2/PaO2 was 0.79 ± 0.14 in moyamoya disease, being lower than 1.10 ± 0.09 in the controls (P < 0.0001). PCSFCO2/PaCO2 was 0.90 ± 0.10 in moyamoya disease, being higher than 0.84 ± 0.07 in the controls (P = 0.0261). PCSFO2/PaO2 was significantly lower in pediatric patients than in adult patients and in the hemispheres with reduced cerebral blood flow (CBF) and cerebrovascular reactivity (CVR) to acetazolamide than in those with normal CBF but reduced CVR. STA-MCA anastomosis significantly increased PCSFO2/PaO2 from 0.79 ± 0.14 to 0.86 ± 0.14 (P < 0.01) and reduced PCSFCO2/PaCO2 from 0.90 ± 0.10 to 0.69 ± 0.16 (P < 0.0001). There was no difference in CSF pH between moyamoya disease and the controls.
UNASSIGNED: PCSFO2/PaO2 was significantly lower in moyamoya disease than in the controls. Its magnitude was more pronounced in pediatric patients than in adult patients and depends on the severity of cerebral ischemia. STA-MCA anastomosis carries dramatic effects on CSF gas tensions in moyamoya patients. CSF may be a valuable biomarker to monitor the pathophysiology of cerebral ischemia/hypoxia in moyamoya disease.
UNASSIGNED: This study included 25 patients with moyamoya disease who underwent STA-MCA anastomosis combined with indirect bypass onto their 34 hemispheres. About 1 mL of CSF was collected before and after bypass procedures to measure CSF partial pressure of oxygen (PCSFO2), CSF partial pressure of carbon dioxide (PCSFCO2), and CSF pH with a blood gas analyzer. As the controls, the CSF was collected from 6 patients during surgery for an unruptured cerebral aneurysm. PCSFO2 and PCSFCO2 were expressed as the ratio to partial pressure of oxygen (PaO2) and partial pressure of carbon dioxide (PaCO2), respectively.
UNASSIGNED: PCSFO2/PaO2 was 0.79 ± 0.14 in moyamoya disease, being lower than 1.10 ± 0.09 in the controls (P < 0.0001). PCSFCO2/PaCO2 was 0.90 ± 0.10 in moyamoya disease, being higher than 0.84 ± 0.07 in the controls (P = 0.0261). PCSFO2/PaO2 was significantly lower in pediatric patients than in adult patients and in the hemispheres with reduced cerebral blood flow (CBF) and cerebrovascular reactivity (CVR) to acetazolamide than in those with normal CBF but reduced CVR. STA-MCA anastomosis significantly increased PCSFO2/PaO2 from 0.79 ± 0.14 to 0.86 ± 0.14 (P < 0.01) and reduced PCSFCO2/PaCO2 from 0.90 ± 0.10 to 0.69 ± 0.16 (P < 0.0001). There was no difference in CSF pH between moyamoya disease and the controls.
UNASSIGNED: PCSFO2/PaO2 was significantly lower in moyamoya disease than in the controls. Its magnitude was more pronounced in pediatric patients than in adult patients and depends on the severity of cerebral ischemia. STA-MCA anastomosis carries dramatic effects on CSF gas tensions in moyamoya patients. CSF may be a valuable biomarker to monitor the pathophysiology of cerebral ischemia/hypoxia in moyamoya disease.
摘要：
■本研究旨在直接测量颞浅动脉与大脑中动脉（STA-MCA）吻合前后的脑脊液（CSF）气体张力和pH值。
■本研究纳入了25例烟雾病患者，他们接受了STA-MCA吻合术结合34个半球的间接旁路手术。在旁路程序之前和之后收集约1mLCSF以测量CSF氧分压（PCSFO2），二氧化碳的CSF分压（PCSFCO2），和CSFpH值用血气分析仪。作为控制，在手术期间收集了6例患者的未破裂脑动脉瘤的CSF.PCSFO2和PCSFCO2表示为氧分压（PaO2）和二氧化碳分压（PaCO2）之比，分别。
■烟雾病中的PCSFO2/PaO2为0.79±0.14，低于对照组的1.10±0.09（P<0.0001）。烟雾病中PCSFCO2/PaCO2为0.90±0.10，高于对照组的0.84±0.07（P=0.0261）。儿童患者的PCSFO2/PaO2明显低于成人患者，脑血流量（CBF）和脑血管对乙酰唑胺反应性（CVR）降低的半球明显低于CBF正常但CVR降低的半球。STA-MCA吻合术使PCSFO2/PaO2从0.79±0.14显著升高至0.86±0.14(P<0.01),PCSFCO2/PaCO2从0.90±0.10显著降低至0.69±0.16(P<0.0001)。烟雾病与对照组之间的CSFpH值没有差异。
■烟雾病中的PCSFO2/PaO2明显低于对照组。其幅度在儿科患者中比在成年患者中更明显，并且取决于脑缺血的严重程度。STA-MCA吻合术对烟雾患者的CSF气体张力具有显着影响。CSF可能是监测烟雾病脑缺血/缺氧病理生理的有价值的生物标志物。
■本研究纳入了25例烟雾病患者，他们接受了STA-MCA吻合术结合34个半球的间接旁路手术。在旁路程序之前和之后收集约1mLCSF以测量CSF氧分压（PCSFO2），二氧化碳的CSF分压（PCSFCO2），和CSFpH值用血气分析仪。作为控制，在手术期间收集了6例患者的未破裂脑动脉瘤的CSF.PCSFO2和PCSFCO2表示为氧分压（PaO2）和二氧化碳分压（PaCO2）之比，分别。
■烟雾病中的PCSFO2/PaO2为0.79±0.14，低于对照组的1.10±0.09（P<0.0001）。烟雾病中PCSFCO2/PaCO2为0.90±0.10，高于对照组的0.84±0.07（P=0.0261）。儿童患者的PCSFO2/PaO2明显低于成人患者，脑血流量（CBF）和脑血管对乙酰唑胺反应性（CVR）降低的半球明显低于CBF正常但CVR降低的半球。STA-MCA吻合术使PCSFO2/PaO2从0.79±0.14显著升高至0.86±0.14(P<0.01),PCSFCO2/PaCO2从0.90±0.10显著降低至0.69±0.16(P<0.0001)。烟雾病与对照组之间的CSFpH值没有差异。
■烟雾病中的PCSFO2/PaO2明显低于对照组。其幅度在儿科患者中比在成年患者中更明显，并且取决于脑缺血的严重程度。STA-MCA吻合术对烟雾患者的CSF气体张力具有显着影响。CSF可能是监测烟雾病脑缺血/缺氧病理生理的有价值的生物标志物。
