# 器官血流压力自动调节的异质性和可变性：100 多年来的经验教训

Heterogeneity and Variability in Pressure Autoregulation of Organ Blood Flow: Lessons Learned Over 100+ Years

Meng L, Wang Y, Zhang L, McDonagh DL. Heterogeneity and Variability in Pressure Autoregulation of Organ Blood Flow: Lessons Learned Over 100+ Years. Crit Care Med. 2019;47(3):436-448. doi:10.1097/CCM.0000000000003569

DeepL 翻译 + 人工校对

# 摘要

Abstract

# 序言

# PA 的研究方法

METHODS INVESTIGATING PA

# 不同器官间 PA 的异质性

HETEROGENEITY OF PA AMONG DIFFERENT ORGANS

# PA 较强的器官

ORGANS WITH ROBUST PA

# 脑血流的 PA

PA of Cerebral Blood Flow

# 脊髓血流的 PA

PA of Spinal Cord Blood Flow

# 冠状动脉血流的 PA

PA of Coronary Blood Flow

# 肾血流的 PA

PA of Renal Blood Flow

# PA 程度中等或较弱的器官

ORGANS WITH MODERATE OR WEAK PA

# 个体间与个体自身 PA 的变异性

INTERINDIVIDUAL VERSUS INTRAINDIVIDUAL VARIABILITY IN PA

# BP 的稳定性、病人预后和动态自动调节

BP LABILITY, PATIENT OUTCOME, AND DYNAMIC AUTOREGULATION

# 100 多年来的经验教训

LESSONS LEARNED OVER 100+ YEARS

# 参考文献

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脓毒症相关的谵妄中的脑灌注。

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心脏骤停患者复苏后的脑血流自动调节.

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在心脏骤停后复苏的病人中，脑部自动调节功能受损。

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暴发性肝衰竭患者的脑灌注、心输出量和动脉压。

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血压变化对脑灌注和氧合的影响。

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降钙素基因相关肽介导硝化甘油和硝普钠诱导的猫科动物脑动脉血管扩张。

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在非人类灵长类动物中，颈内腺苷而非硝普钠可增加脑血流量。

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颈动脉内硝普钠不会增加人类的脑血流量。

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去甲肾上腺素、肾上腺素和血管紧张素对人的颈内动脉血流的影响。

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颈内肾上腺素、去甲肾上腺素和血管紧张素对人的区域脑血流的影响。

88. Moerman AT, Vanbiervliet VM, Van Wesemael A, et al. Assessment of cerebral autoregulation patterns with near-infrared spectroscopy during pharmacological-induced pressure changes. Anesthesiology 2015; 123:327-335.
在药物诱导的压力变化过程中用近红外光谱法评估大脑血流自动调节模式。

89. Meng L, Cannesson M, Alexander BS, et al. Effect of phenylephrine and ephedrine bolus treatment on cerebral oxygenation in anaesthetized patients. Br J Anaesth 2011; 107:209-217.
苯肾上腺素和麻黄素栓塞治疗对麻醉病人脑氧合的影响。

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丙泊酚 - 瑞芬太尼或七氟烷麻醉过程中的脑血流动力学变化：双光谱指数监测下的经颅多普勒研究。

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丙泊酚对麻醉猪的脑血流、代谢和脑血流自动调节的影响。

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七氟烷麻醉期间动态脑血流自动调节。与异氟烷的比较。

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交感神经活动对脑血流的影响。

95. Zhang R, Zuckerman JH, Iwasaki K, et al. Autonomic neural control of dynamic cerebral autoregulation in humans. Circulation 2002; 106:1814-1820.
人类动态脑血流自动调节的自主神经控制。

96. van Lieshout JJ, Secher NH. Point:Counterpoint: Sympathetic activity does/does not influence cerebral blood flow. Point: Sympathetic activity does influence cerebral blood flow. J Appl Physiol (1985) 2008; 105:1364-1366.
点。交感神经活动确实影响脑血流。

97. Willie CK, Tzeng YC, Fisher JA, et al. Integrative regulation of human brain blood flow. J Physiol 2014; 592:841-859.
人脑血流的综合调节。

98. Crystal GJ, Czinn EA, Salem MR. The mechanism of increased blood flow in the brain and spinal cord during hemodilution. Anesth Analg 2014; 118:637-643.
血液稀释时大脑和脊髓血流增加的机制。

99. Czinn EA, Salem MR, Crystal GJ. Hemodilution impairs hypocapnia-induced vasoconstrictor responses in the brain and spinal cord in dogs. Anesth Analg 1995; 80:492-498.
血液稀释会损害低碳酸血症引起的狗脑和脊髓的血管收缩反应。

100. Brown MM, Wade JP, Marshall J. Fundamental importance of arterial oxygen content in the regulation of cerebral blood flow in man. Brain 1985; 108(Pt 1):81-93.
动脉含氧量对人的脑血流调节的根本重要性。

101. Brown MM, Marshall J. Regulation of cerebral blood flow in response to changes in blood viscosity. Lancet 1985; 1:604-609.
对血液粘度变化的脑血流调节。

102. McCulloch TJ, Visco E, Lam AM. Graded hypercapnia and cerebral autoregulation during sevoflurane or propofol anesthesia. Anesthesiology 2000; 93:1205-1209.
七氟醚或丙泊酚麻醉期间的分级高碳酸血症和脑部自动调节。

103. Field EJ, Grayson J, Rogers AF. Observations on the blood flow in the spinal cord of the rabbit. J Physiol 1951; 114:56-70.
对兔子脊髓血流的观察。

104. Guha A, Tator CH, Rochon J. Spinal cord blood flow and systemic blood pressure after experimental spinal cord injury in rats. Stroke 1989; 20:372-377.
大鼠实验性脊髓损伤后的脊髓血流和全身血压。

105. Smith AJ, McCreery DB, Bloedel JR, et al. Hyperemia, CO₂ responsiveness, and autoregulation in the white matter following experimental spinal cord injury. J Neurosurg 1978; 48:239-251.
实验性脊髓损伤后白质中的高血症、二氧化碳反应性和自动调节。

106. Griffiths IR. Spinal cord blood flow after acute experimental cord injury in dogs. J Neurol Sci 1976; 27:247-259.
狗急性实验性脊髓损伤后的脊髓血流。

107. Werner C, Hoffman WE, Kochs E, et al. The effects of propofol on cerebral and spinal cord blood flow in rats. Anesth Analg 1993; 76:971-975.
丙泊酚对大鼠脑和脊髓血流的影响。

108. Kobrine AI, Evans DE, Rizzoli HV. The effect of alpha adrenergic blockade on spinal cord autoregulation in the monkey. J Neurosurg 1977; 46:336-341.
α 肾上腺素能阻断对猴子脊髓自动调节的影响。

109. Kobrine AI, Evans DE, Rizzoli HV. The effects of beta adrenergic blockade on spinal cord autoregulation in the monkey. J Neurosurg 1977; 47:57-63.
β 肾上腺素能阻断对猴子脊髓自动调节的影响.

110. Duncker DJ, Bache RJ. Regulation of coronary blood flow during exercise. Physiol Rev 2008; 88:1009-1086.
运动中冠状动脉血流的调节。

111. Berne RM. Regulation of coronary blood flow. Physiol Rev 1964; 44:1-29.
冠状动脉血流的调节。

112. Feigl EO. Coronary autoregulation. J Hypertens Suppl 1989; 7:S55-S58; discussion S59.
冠状动脉自动调节。

113. Canty JM Jr. Coronary pressure-function and steady-state pressure-flow relations during autoregulation in the unanesthetized dog. Circ Res 1988; 63:821-836.
未麻醉的狗在自动调节期间的冠状动脉压力 - 功能和稳态压力 - 流量关系。

114. Feigl EO. Coronary physiology. Physiol Rev 1983; 63:1-205.
冠状动脉生理学。

115. Hoffman JI, Spaan JA. Pressure-flow relations in coronary circulation. Physiol Rev 1990; 70:331-390.
冠状动脉循环中的压力 - 流量关系。

116. Westerhof N, Boer C, Lamberts RR, et al. Cross-talk between cardiac muscle and coronary vasculature. Physiol Rev 2006; 86:1263-1308.
心肌和冠状动脉血管之间的交叉对话。

117. Dole WP. Autoregulation of the coronary circulation. Prog Cardiovasc Dis 1987; 29:293-323.
冠状动脉循环的自动调节。

118. Yonekura S, Watanabe N, Caffrey JL, et al. Mechanism of attenuated pressure-flow autoregulation in right coronary circulation of dogs. Circ Res 1987; 60:133-141.
狗右冠状动脉循环中压力 - 流量自动调节减弱的机制。

119. Tani H, Saito D, Kusachi S, et al. Autoregulation by the right coronary artery in dogs with open chests; comparison with the left coronary artery. Pflugers Arch 1990; 416:442-447.
开胸狗的右冠状动脉的自动调节；与左冠状动脉的比较。

120. Guth BD, Schulz R, Heusch G. Pressure-flow characteristics in the right and left ventricular perfusion territories of the right coronary artery in swine. Pflugers Arch 1991; 419:622-628.
猪右冠状动脉的右心室和左心室灌注区的压力 - 流量特征。

121. Boatwright RB, Downey HF, Bashour FA, et al. Transmural variation in autoregulation of coronary blood flow in hyperperfused canine myocardium. Circ Res 1980; 47:599-609.
灌注过度的犬类心肌中冠状动脉血流自动调节的跨膜变化。

122. Guyton RA, McClenathan JH, Newman GE, et al. Significance of subendocardial S-T segment elevation caused by coronary stenosis in the dog. Epicardial S-T segment depression, local ischemia and subsequent necrosis. Am J Cardiol 1977; 40:373-380.
心外膜 S-T 段压低，局部缺血和随后的坏死。

123. Rouleau J, Boerboom LE, Surjadhana A, et al. The role of autoregulation and tissue diastolic pressures in the transmural distribution of left ventricular blood flow in anesthetized dogs. Circ Res 1979; 45:804-815.
自动调节和组织舒张压在麻醉犬左心室血流跨膜分布中的作用。

124. Yonekura S, Watanabe N, Downey HF. Transmural variation in autoregulation of right ventricular blood flow. Circ Res 1988; 62:776-781.
右心室血流自动调节的横断面变化。

125. Polese A, De Cesare N, Montorsi P, et al. Upward shift of the lower range of coronary flow autoregulation in hypertensive patients with hypertrophy of the left ventricle. Circulation 1991; 83:845-853.
左心室肥大的高血压患者的冠状动脉血流自动调节的低范围向上移动。

126. Canty JM Jr, Giglia J, Kandath D. Effect of tachycardia on regional function and transmural myocardial perfusion during graded coronary pressure reduction in conscious dogs. Circulation 1990; 82:1815-1825.
心动过速对意识清醒的狗在冠状动脉分级减压时区域功能和跨膜心肌灌注的影响。

127. Bian X, Williams AG Jr, Gwirtz PA, et al. Right coronary autoregulation in conscious, chronically instrumented dogs. Am J Physiol 1998; 275:H169-H175.
昏迷狗的右冠状动脉自动调节功能。

128. Hickey RF, Sybert PE, Verrier ED, et al. Effects of halothane, enflurane, and isoflurane on coronary blood flow autoregulation and coronary vascular reserve in the canine heart. Anesthesiology 1988; 68:21-30.
氟烷、恩氟烷和异氟烷对犬心脏冠状动脉血流自动调节和冠状动脉血管储备的影响。

129. Iversen BM, Sekse I, Ofstad J. Resetting of renal blood flow autoregulation in spontaneously hypertensive rats. Am J Physiol 1987; 252:F480-F486.
自发性高血压大鼠肾血流自动调节的复位。

130. Hayashi K, Epstein M, Loutzenhiser R. Pressure-induced vasoconstriction of renal microvessels in normotensive and hypertensive rats. Studies in the isolated perfused hydronephrotic kidney. Circ Res 1989; 65:1475-1484.
在分离的灌注水肾中的研究。

131. Hayashi K, Epstein M, Saruta T. Altered myogenic responsiveness of the renal microvasculature in experimental hypertension. J Hypertens 1996; 14:1387-1401.
实验性高血压中肾脏微血管的肌源反应性改变。

132. Hashimoto Y, Ideura T, Yoshimura A, et al. Autoregulation of renal blood flow in streptozocin-induced diabetic rats. Diabetes 1989; 38:1109-1113.
Streptozocin 诱导的糖尿病大鼠肾血流的自动调节。

133. Hayashi K, Epstein M, Loutzenhiser R, et al. Impaired myogenic responsiveness of the afferent arteriole in streptozotocin-induced diabetic rats: Role of eicosanoid derangements. J Am Soc Nephrol 1992; 2:1578-1586.
链脲霉素诱导的糖尿病大鼠传入动脉血管的肌源性反应性受损。二十烷烃类物质失调的作用。

134. Ishida K, Ishibashi F, Takashina S. Comparison of renal hemodynamics in early non-insulin-dependent and insulin-dependent diabetes mellitus. J Diabet Complications 1991; 5:143-145.
早期非胰岛素依赖型和胰岛素依赖型糖尿病的肾脏血流动力学比较。

135. Tolins JP, Shultz PJ, Raij L, et al. Abnormal renal hemodynamic response to reduced renal perfusion pressure in diabetic rats: Role of NO. Am J Physiol 1993; 265:F886-F895.
糖尿病大鼠肾血流动力学对肾灌注压降低的异常反应。NO 的作用。

136. De Micheli AG, Forster H, Duncan RC, et al. A quantitative assessment of renal blood flow autoregulation in experimental diabetes. Nephron 1994; 68:245-251.
实验性糖尿病中肾脏血流自动调节的定量评估.

137. Mauer SM, Brown DM, Steffes MW, et al. Studies of renal autoregulation in pancreatectomized and streptozotocin diabetic rats. Kidney Int 1990; 37:909-917.
胰腺切除和链脲霉素糖尿病大鼠肾脏自动调节的研究。

138. Parving HH, Kastrup H, Smidt UM, et al. Impaired autoregulation of glomerular filtration rate in type 1 (insulin-dependent) diabetic patients with nephropathy. Diabetologia 1984; 27:547-552.
1 型（胰岛素依赖型）糖尿病患者肾小球滤过率的自动调节功能受损。

139. New JP, Marshall SM, Bilous RW. Renal autoregulation is normal in newly diagnosed, normotensive, NIDDM patients. Diabetologia 1998; 41:206-211.
新诊断的、血压正常的 NIDDM 患者的肾脏自动调节功能是正常的。

140. Ogawa N, Ono H. Role of Ca channel in the renal autoregulatory vascular response analysed by the use of BAY K 8644. Naunyn Schmiedebergs Arch Pharmacol 1987; 335:189-193.
通过使用 BAY K 8644 分析 Ca 通道在肾脏自动调节血管反应中的作用。

141. Christensen PK, Akram K, Konig KB, et al. Autoregulation of glomerular filtration rate in patients with type 2 diabetes during isradipine therapy. Diabetes Care 2003; 26:156-162.
2 型糖尿病患者在接受伊拉地平治疗期间肾小球滤过率的自我调节。

142. Bugge JF, Stokke ES, Kiil F. Effects of bradykinin and papaverine on renal autoregulation and renin release in the anaesthetized dog. Acta Physiol Scand 1991; 143:431-437.
缓激肽和罂粟碱对麻醉狗肾脏自动调节和肾素释放的影响。

143. Ohmura A, Wong KC, Pace NL, et al. Effects of halothane and sodium nitroprusside on renal function and autoregulation. Br J Anaesth 1982; 54:103-108.
氟烷和硝普钠对肾功能和自动调节的影响。

144. Bastron RD, Perkins RM, Pyne JL. Autoregulation of renal blood flow during halothane anesthesia. Anesthesiology 1977; 46:142-144.
氟烷麻醉期间肾脏血流的自动调节。

145. Pappenheimer JR, Maes JP. A quantitative measure of the vasomotor tone in the hindlimb muscles of the dog. Am J Physiol 1942; 137:187-199.
对狗后肢肌肉血管运动张力的定量测量。

146. Folkow B. A critical study of some methods used in investigations on the blood circulation. Acta Physiologica 1953; 27:118-129.
对血液循环调查中使用的一些方法的批评研究。

147. Green HD, Lewis RN, Nickerson ND, et al. Blood flow, peripheral resistance and vascular tonus, with observations on the relationship between blood flow and cutaneous temperature. Am J Physiol 1944; 141:518-536.
血流、外周阻力和血管张力，以及对血流和皮肤温度之间关系的观察。

148. Folkow B. Intravascular pressure as a factor regulating the tone of the small vessels. Acta Physiologica 1949; 17:289-310.
血管内压是调节小血管张力的一个因素。

149. Faris I, Vagn Nielsen H, Henriksen O, et al. Impaired autoregulation of blood flow in skeletal muscle and subcutaneous tissue in long-term type 1 (insulin-dependent) diabetic patients with microangiopathy. Diabetologia 1983; 25:486-488.
长期患有微血管病的 1 型（胰岛素依赖型）糖尿病患者的骨骼肌和皮下组织的血流自动调节功能受损。

150. Kastrup J, Norgaard T, Parving HH, et al. Impaired autoregulation of blood flow in subcutaneous tissue of long-term type 1 (insulin-dependent) diabetic patients with microangiopathy: An index of arteriolar dysfunction. Diabetologia 1985; 28:711-717.
长期患有微血管病变的 1 型（胰岛素依赖型）糖尿病患者皮下组织的血流自动调节功能受损。动脉功能障碍的一个指标。

151. De Blasi RA, Palmisani S, Alampi D, et al. Microvascular dysfunction and skeletal muscle oxygenation assessed by phase-modulation near-infrared spectroscopy in patients with septic shock. Intensive Care Med 2005; 31:1661-1668.
用相位调制近红外光谱法评估脓毒症休克患者的微血管功能障碍和骨骼肌氧合情况。

152. Jacobson ED, Scott JB, Frohlich ED. Hemodynamics of the stomach. I. Resistance-flow relationship in the gastric vascular bed. Am J Dig Dis 1962; 7:779-785.
胃血管床的阻力 - 流量关系。

153. Bruggeman TM, Wood JG, Davenport HW. Local control of blood flow in the dog's stomach: Vasodilatation caused by acid back-diffusion following topical application of salicylic acid. Gastroenterology 1979; 77:736-744.
狗胃中血流的局部控制。局部使用水杨酸后酸液回渗引起的血管舒张。

154. Holm-Rutili L, Perry MA, Granger DN. Autoregulation of gastric blood flow and oxygen uptake. Am J Physiol 1981; 241:G143-G149.
胃血流和氧摄取的自动调节。

155. Perry MA, Murphree D, Granger DN. Oxygen uptake as a determinant of gastric blood flow autoregulation. Dig Dis Sci 1982; 27:675-679.
摄氧量是胃血流自动调节的一个决定因素。

156. Selkurt EE, Scibetta MP, Cull TE. Hemodynamics of intestinal circulation. Circ Res 1958; 6:92-99.
肠道循环的血流动力学。

157. Texter EC Jr, Merrill S, Schwartz M, et al. Relationship of blood flow to pressure in the intestinal vascular bed of the dog. Am J Physiol 1962; 202:253-256.
狗肠道血管床的血流与压力的关系。

158. Richardson DR, Johnson PC. Comparison of autoregulatory escape and autoregulation in the intestinal vascular bed. Am J Physiol 1969; 217:586-590.
肠道血管床的自动调节逃逸和自动调节的比较。

159. Shepherd AP, Granger HJ. Autoregulatory escape in the gut: A systems analysis. Gastroenterology 1973; 65:77-91.
肠道内的自动调节逃逸。一个系统分析。

160. Johnson PC, Hanson KM. Effect of arterial pressure on arterial and venous resistance of intestine. J Appl Physiol 1962; 17:503-508.
动脉压力对肠道的动脉和静脉阻力的影响。

161. Hanson KM, Johnson PC. Pressure-flow relationships in isolated dog colon. Am J Physiol 1967; 212:574-578.
分离的狗结肠中的压力 - 流量关系。

162. Hanson KM, Moore FT. Effects of intraluminal pressure in the colon on its vascular pressure-flow relationships. Proc Soc Exp Biol Med 1969; 131:373-376.
结肠腔内压力对其血管压力 - 流量关系的影响。

163. Richardson PD, Withrington PG. Pressure-flow relationships and effects of noradrenaline and isoprenaline on the hepatic arterial and portal venous vascular beds of the dog. J Physiol 1978; 282:451-470.
去甲肾上腺素和异丙肾上腺素的压力 - 流量关系和对狗肝动脉和门静脉血管床的影响。

164. Norris CP, Barnes GE, Smith EE, et al. Autoregulation of superior mesenteric flow in fasted and fed dogs. Am J Physiol 1979; 237:H174-H177.
空腹和进食的狗的肠系膜上层血流的自动调节。

165. Drummond JC. The lower limit of autoregulation: Time to revise our thinking? Anesthesiology 1997; 86:1431-1433.
自动调节的下限。是时候修改我们的想法了吗？

166. Bombardieri AM, Sharrock NE, Ma Y, et al. An observational study of cerebral blood flow velocity during hypotensive epidural anesthesia. Anesth Analg 2016; 122:226-233.
低血压硬膜外麻醉期间脑血流速度的观察性研究。

167. Larsen FS, Olsen KS, Hansen BA, et al. Transcranial Doppler is valid for determination of the lower limit of cerebral blood flow autoregulation. Stroke 1994; 25:1985-1988.
经颅多普勒对确定脑血流自动调节的下限是有效的。

168. Aronson S, Stafford-Smith M, Phillips-Bute B, et al; Cardiothoracic Anesthesiology Research Endeavors: Intraoperative systolic blood pressure variability predicts 30-day mortality in aortocoronary bypass surgery patients. Anesthesiology 2010; 113:305-312.
Aronson S, Stafford-Smith M, Phillips-Bute B, et al; Cardiothoracic Anesthesiology Research Endeavors: 术中收缩压变异性可预测主动脉冠状动脉搭桥手术患者 30 天的死亡率。

169. Aronson S, Dyke CM, Levy JH, et al. Does perioperative systolic blood pressure variability predict mortality after cardiac surgery? An exploratory analysis of the ECLIPSE trials. Anesth Analg 2011; 113:19-30.
围手术期收缩压变异性可预测心脏手术后的死亡率吗？对 ECLIPSE 试验的探索性分析。

170. Hirsch J, DePalma G, Tsai TT, et al. Impact of intraoperative hypotension and blood pressure fluctuations on early postoperative delirium after non-cardiac surgery. Br J Anaesth 2015; 115:418-426.
术中低血压和血压波动对非心脏手术后早期谵妄的影响.

171. Mascha EJ, Yang D, Weiss S, et al. Intraoperative mean arterial pressure variability and 30-day mortality in patients having noncardiac surgery. Anesthesiology 2015; 123:79-91.
非心脏手术患者的术中平均动脉压变异性和 30 天的死亡率。

172. Levin MA, Fischer GW, Lin HM, et al. Intraoperative arterial blood pressure lability is associated with improved 30 day survival. Br J Anaesth 2015; 115:716-726.
术中动脉血压的稳定性与 30 天生存率的提高有关。

173. Ono M, Arnaoutakis GJ, Fine DM, et al. Blood pressure excursions below the cerebral autoregulation threshold during cardiac surgery are associated with acute kidney injury. Crit Care Med 2013; 41:464-471.
心脏手术期间血压偏移低于脑血流自动调节阈值与急性肾脏损伤有关。

174. Overgaard J, Tweed WA. Cerebral circulation after head injury. 1. Cerebral blood flow and its regulation after closed head injury with emphasis on clinical correlations. J Neurosurg 1974; 41:531-541.
闭合性头部损伤后的脑血流及其调节，强调临床相关性。

175. Cold GE, Jensen FT. Cerebral autoregulation in unconscious patients with brain injury. Acta Anaesthesiol Scand 1978; 22:270-280.
昏迷中的脑损伤患者的脑自主调节.

176. Brady KM, Shaffner DH, Lee JK, et al. Continuous monitoring of cerebrovascular pressure reactivity after traumatic brain injury in children. Pediatrics 2009; 124:e1205-e1212.
儿童脑外伤后脑血管压力反应性的连续监测.

177. Bowles AP, Pasierb L, Simunich T, et al. Implications of neurophysiological parameters in persons with severe brain injury with respect to improved patient outcomes: A retrospective review. Brain Inj 2012; 26:1415-1424.
严重脑损伤患者的神经生理参数对改善患者预后的意义。一个回顾性的回顾。

178. Sorrentino E, Diedler J, Kasprowicz M, et al. Critical thresholds for cerebrovascular reactivity after traumatic brain injury. Neurocrit Care 2012; 16:258-266.
创伤性脑损伤后脑血管反应性的关键阈值。

179. Aries MJ, Czosnyka M, Budohoski KP, et al. Continuous monitoring of cerebrovascular reactivity using pulse waveform of intracranial pressure. Neurocrit Care 2012; 17:67-76.
使用颅内压的脉冲波形连续监测脑血管反应性。

180. Lang EW, Kasprowicz M, Smielewski P, et al. Outcome, pressure reactivity and optimal cerebral perfusion pressure calculation in traumatic brain injury: A comparison of two variants. Acta Neurochir Suppl 2016; 122:221-223.
创伤性脑损伤的结果、压力反应性和最佳脑灌注压计算。两种变体的比较。

181. Aries MJ, Wesselink R, Elting JW, et al. Enhanced visualization of optimal cerebral perfusion pressure over time to support clinical decision making. Crit Care Med 2016; 44:e996-e999.
增强最佳脑灌注压随时间变化的可视化，以支持临床决策。

182. Donnelly J, Czosnyka M, Adams H, et al. Individualizing thresholds of cerebral perfusion pressure using estimated limits of autoregulation. Crit Care Med 2017; 45:1464-1471.
利用估计的自动调节极限来确定脑灌注压的个体化阈值。

183. Bedforth NM, Girling KJ, Skinner HJ, et al. Effects of desflurane on cerebral autoregulation. Br J Anaesth 2001; 87:193-197.
地氟醚对大脑血流自动调节的影响。

184. Matta BF, Mayberg TS, Lam AM. Direct cerebrovasodilatory effects of halothane, isoflurane, and desflurane during propofol-induced isoelectric electroencephalogram in humans. Anesthesiology 1995; 83:980-985; discussion 27A.
氟烷、异氟烷和地氟烷在丙泊酚诱导的人体等电位脑电图中的直接脑血管扩张作用。

185. McCulloch TJ, Boesel TW, Lam AM. The effect of hypocapnia on the autoregulation of cerebral blood flow during administration of isoflurane. Anesth Analg 2005; 100:1463-1467.
异氟醚给药期间低碳酸血症对脑血流自动调节的影响。

186. Fieschi C, Battistini N, Beduschi A, et al. Regional cerebral blood flow and intraventricular pressure in acute head injuries. J Neurol Neurosurg Psychiatry 1974; 37:1378-1388.
急性颅脑损伤的区域脑血流和脑室内压。

187. Czosnyka M, Balestreri M, Steiner L, et al. Age, intracranial pressure, autoregulation, and outcome after brain trauma. J Neurosurg 2005; 102:450-454.
年龄、颅内压、自动调节和脑外伤后的结果。

188. Czosnyka M, Smielewski P, Kirkpatrick P, et al. Continuous assessment of the cerebral vasomotor reactivity in head injury. Neurosurgery 1997; 41:11-17.
连续评估头部受伤时的脑血管运动反应性。

189. Czosnyka M, Smielewski P, Kirkpatrick P, et al. Monitoring of cerebral autoregulation in head-injured patients. Stroke 1996; 27:1829-1834.
监测头部受伤患者的脑部自动调节功能。

190. Lam JM, Hsiang JN, Poon WS. Monitoring of autoregulation using laser Doppler flowmetry in patients with head injury. J Neurosurg 1997; 86:438-445.
用激光多普勒血流仪监测头部受伤患者的自动调节功能。

191. Steiner LA, Czosnyka M, Piechnik SK, et al. Continuous monitoring of cerebrovascular pressure reactivity allows determination of optimal cerebral perfusion pressure in patients with traumatic brain injury. Crit Care Med 2002; 30:733-738.
连续监测脑血管压力反应性可以确定脑外伤患者的最佳脑灌注压力。

192. Balestreri M, Czosnyka M, Steiner LA, et al. Intracranial hypertension: What additional information can be derived from ICP waveform after head injury? Acta Neurochir (Wien) 2004; 146:131-141.
颅内高血压。头部受伤后，从 ICP 波形中可以得到哪些额外信息？

193. Jaeger M, Schuhmann MU, Soehle M, et al. Continuous assessment of cerebrovascular autoregulation after traumatic brain injury using brain tissue oxygen pressure reactivity. Crit Care Med 2006; 34:1783-1788.
利用脑组织氧压反应性连续评估脑外伤后的脑血管自动调节功能。

194. Reinert M, Andres RH, Fuhrer M, et al. Online correlation of spontaneous arterial and intracranial pressure fluctuations in patients with diffuse severe head injury. Neurol Res 2007; 29:455-462.
弥漫性重度颅脑损伤患者的自发动脉和颅内压波动的在线相关性。

195. Radolovich DK, Aries MJ, Castellani G, et al. Pulsatile intracranial pressure and cerebral autoregulation after traumatic brain injury. Neurocrit Care 2011; 15:379-386.
脉动性颅内压和脑部自动调节在脑外伤后的应用。

196. Sorrentino E, Budohoski KP, Kasprowicz M, et al. Critical thresholds for transcranial Doppler indices of cerebral autoregulation in traumatic brain injury. Neurocrit Care 2011; 14:188-193.
创伤性脑损伤中经颅多普勒脑血流自动调节指数的临界值。

197. Depreitere B, Guiza F, Van den Berghe G, et al. Pressure autoregulation monitoring and cerebral perfusion pressure target recommendation in patients with severe traumatic brain injury based on minute-by-minute monitoring data. J Neurosurg 2014; 120:1451-1457.
基于每分钟的监测数据，严重脑外伤患者的压力自律监测和脑灌注压目标建议。

198. Dias C, Silva MJ, Pereira E, et al. Optimal cerebral perfusion pressure management at bedside: A single-center pilot study. Neurocrit Care 2015; 23:92-102.
最佳的床边脑灌注压管理。一个单中心的试点研究。

199. Petkus V, Krakauskaite S, Preiksaitis A, et al. Association between the outcome of traumatic brain injury patients and cerebrovascular autoregulation, cerebral perfusion pressure, age, and injury grades. Medicina (Kaunas) 2016; 52:46-53.
脑外伤患者的结局与脑血管自动调节、脑灌注压、年龄和损伤等级之间的关系。

200. Preiksaitis A, Krakauskaite S, Petkus V, et al. Association of severe traumatic brain injury patient outcomes with duration of cerebrovascular autoregulation impairment events. Neurosurgery 2016; 79:75-82.
严重脑外伤患者结局与脑血管自动调节功能受损事件持续时间的关系。

201. Jaeger M, Soehle M, Schuhmann MU, et al. Clinical significance of impaired cerebrovascular autoregulation after severe aneurysmal subarachnoid hemorrhage. Stroke 2012; 43:2097-2101.
严重动脉瘤性蛛网膜下腔出血后脑血管自动调节功能受损的临床意义。

202. Budohoski KP, Czosnyka M, Smielewski P, et al. Impairment of cerebral autoregulation predicts delayed cerebral ischemia after subarachnoid hemorrhage: A prospective observational study. Stroke 2012; 43:3230-3237.
大脑血流自动调节功能受损可预测蛛网膜下腔出血后的延迟性脑缺血。一项前瞻性的观察研究。

203. Rasulo FA, Girardini A, Lavinio A, et al. Are optimal cerebral perfusion pressure and cerebrovascular autoregulation related to long-term outcome in patients with aneurysmal subarachnoid hemorrhage? J Neurosurg Anesthesiol 2012; 24:3-8.
最佳脑灌注压和脑血管自动调节与动脉瘤性蛛网膜下腔出血患者的长期疗效有关吗？

204. Eide PK, Sorteberg A, Bentsen G, et al. Pressure-derived versus pressure wave amplitude-derived indices of cerebrovascular pressure reactivity in relation to early clinical state and 12-month outcome following aneurysmal subarachnoid hemorrhage. J Neurosurg 2012; 116:961-971.
压力衍生与压力波幅衍生的脑血管压力反应性指数与动脉瘤蛛网膜下腔出血后早期临床状态和 12 个月预后的关系。

205. Otite F, Mink S, Tan CO, et al. Impaired cerebral autoregulation is associated with vasospasm and delayed cerebral ischemia in subarachnoid hemorrhage. Stroke 2014; 45:677-682.
大脑血流自动调节功能受损与蛛网膜下腔出血的血管痉挛和延迟性脑缺血有关。

206. Diedler J, Santos E, Poli S, et al. Optimal cerebral perfusion pressure in patients with intracerebral hemorrhage: An observational case series. Crit Care 2014; 18:R51.
脑内出血患者的最佳脑灌注压。一个观察性的病例系列。

207. Calviere L, Nasr N, Arnaud C, et al. Prediction of delayed cerebral ischemia after subarachnoid hemorrhage using cerebral blood flow velocities and cerebral autoregulation assessment. Neurocrit Care 2015; 23:253-258.
利用脑血流速度和脑血流自动调节评估预测蛛网膜下腔出血后的延迟性脑缺血。

208. Reinhard M, Neunhoeffer F, Gerds TA, et al. Secondary decline of cerebral autoregulation is associated with worse outcome after intracerebral hemorrhage. Intensive Care Med 2010; 36:264-271.
大脑血流自动调节功能的继发性下降与脑内出血后较差的预后有关。

209. Barth M, Moratin B, Dostal M, et al. Correlation of clinical outcome and angiographic vasospasm with the dynamic autoregulatory response after aneurysmal subarachnoid hemorrhage. Acta Neurochir Suppl 2012; 114:157-160.
动脉瘤性蛛网膜下腔出血后临床结果和血管痉挛与动态自动调节反应的相关性。

210. Oeinck M, Neunhoeffer F, Buttler KJ, et al. Dynamic cerebral autoregulation in acute intracerebral hemorrhage. Stroke 2013; 44:2722-2728.
急性脑内出血的动态脑自主调节.

211. Fontana J, Moratin J, Ehrlich G, et al. Dynamic autoregulatory response after aneurysmal subarachnoid hemorrhage and its relation to angiographic vasospasm and clinical outcome. Neurocrit Care 2015; 23:355-363.
动脉瘤性蛛网膜下腔出血后的动态自动调节反应及其与血管痉挛和临床结果的关系。

212. Santos GA, Petersen N, Zamani AA, et al. Pathophysiologic differences in cerebral autoregulation after subarachnoid hemorrhage. Neurology 2016; 86:1950-1956.
蛛网膜下腔出血后脑部自动调节的病理生理学差异。

213. Newman MF, Croughwell ND, Blumenthal JA, et al. Effect of aging on cerebral autoregulation during cardiopulmonary bypass. Association with postoperative cognitive dysfunction. Circulation 1994; 90:II243-II249.
与术后认知功能障碍的关系。

214. Joshi B, Brady K, Lee J, et al. Impaired autoregulation of cerebral blood flow during rewarming from hypothermic cardiopulmonary bypass and its potential association with stroke. Anesth Analg 2010; 110:321-328.
低温心肺分流术后复温过程中的脑血流自动调节功能受损及其与中风的潜在联系。

215. Zheng Y, Villamayor AJ, Merritt W, et al. Continuous cerebral blood flow autoregulation monitoring in patients undergoing liver transplantation. Neurocrit Care 2012; 17:77-84.
肝移植患者的连续脑血流自动调节监测。

216. Ono M, Brady K, Easley RB, et al. Duration and magnitude of blood pressure below cerebral autoregulation threshold during cardiopulmonary bypass is associated with major morbidity and operative mortality. J Thorac Cardiovasc Surg 2014; 147:483-489.
在心肺分流过程中，血压低于大脑血流自动调节阈值的时间和幅度与主要的发病率和手术死亡率有关。

217. Hori D, Brown C, Ono M, et al. Arterial pressure above the upper cerebral autoregulation limit during cardiopulmonary bypass is associated with postoperative delirium. Br J Anaesth 2014; 113:1009-1017.
在心肺分流术期间，动脉压高于大脑血流自动调节上限与术后谵妄有关。

218. Hori D, Max L, Laflam A, et al. Blood pressure deviations from optimal mean arterial pressure during cardiac surgery measured with a novel monitor of cerebral blood flow and risk for perioperative delirium: A pilot study. J Cardiothorac Vasc Anesth 2016; 30:606-612.
用新型脑血流监测仪测量的心脏手术期间的血压偏离最佳平均动脉压和围手术期谵妄的风险。一个试点研究。

219. Laflam A, Joshi B, Brady K, et al. Shoulder surgery in the beach chair position is associated with diminished cerebral autoregulation but no differences in postoperative cognition or brain injury biomarker levels compared with supine positioning: The anesthesia patient safety foundation beach chair study. Anesth Analg 2015; 120:176-185.
沙滩椅体位下的肩部手术与脑自主调节功能减弱有关，但与仰卧位相比，术后认知能力或脑损伤生物标志物水平没有差异。麻醉病人安全基金会沙滩椅研究。

220. Goettel N, Burkhart CS, Rossi A, et al. Associations between impaired cerebral blood flow autoregulation, cerebral oxygenation, and biomarkers of brain injury and postoperative cognitive dysfunction in elderly patients after major noncardiac surgery. Anesth Analg 2017; 124:934-942.
老年非心脏大手术后患者脑血流自动调节功能受损、脑氧合、脑损伤生物标志物与术后认知功能障碍的关系。

221. Rickards CA. Cerebral blood-flow regulation during hemorrhage. Compr Physiol 2015; 5:1585-1621.
出血时的脑血流调节.

222. Meng L, Yu W, Wang T, et al. Blood pressure targets in perioperative care: Provisional considerations based on a comprehensive literature review. Hypertension 2018; 72:806-817.
围手术期救治中的血压目标。基于综合文献回顾的临时考虑。

223. Neutze JM, Wyler F, Rudolph AM. Use of radioactive microspheres to assess distribution of cardiac output in rabbits. Am J Physiol 1968; 215:486-495.
使用放射性微球来评估兔子的心输出量分布。

224. Neutze JM, Wyler F, Rudolph AM. Changes in distribution of cardiac output after hemorrhage in rabbits. Am J Physiol 1968; 215:857-864.
兔子出血后心输出量分布的变化.

225. Fell C. Changes in distribution of blood flow in irreversible hemorrhagic shock. Am J Physiol 1966; 210:863-868.
不可逆转的失血性休克中血流分布的变化。

226. Ogoh S, Brothers RM, Barnes Q, et al. The effect of changes in cardiac output on middle cerebral artery mean blood velocity at rest and during exercise. J Physiol 2005; 569:697-704.
心输出量的变化对休息和运动时大脑中动脉平均血流速度的影响。

227. Levine BD, Giller CA, Lane LD, et al. Cerebral versus systemic hemodynamics during graded orthostatic stress in humans. Circulation 1994; 90:298-306.
人类在分级正位压力下的大脑与全身血流动力学。

228. Numan T, Bain AR, Hoiland RL, et al. Static autoregulation in humans: A review and reanalysis. Med Eng Phys 2014; 36:1487-1495.
人类的静态自动调节。回顾和重新分析.

229. Panerai RB. Assessment of cerebral pressure autoregulation in humans-a review of measurement methods. Physiol Meas 1998; 19:305-338.
人类脑压自动调节的评估 - 测量方法的回顾.

230. Hamner JW, Tan CO. Relative contributions of sympathetic, cholinergic, and myogenic mechanisms to cerebral autoregulation. Stroke 2014; 45:1771-1777.
交感神经、胆碱能和肌源性机制对大脑血流自动调节的相对贡献。

231. Tan CO. Defining the characteristic relationship between arterial pressure and cerebral flow. J Appl Physiol (1985) 2012; 113:1194-1200.
界定动脉压和脑流量之间的特征关系。

232. Kontos HA, Wei EP, Navari RM, et al. Responses of cerebral arteries and arterioles to acute hypotension and hypertension. Am J Physiol 1978; 234:H371-H383.
大脑动脉和小动脉对急性低血压和高血压的反应。

233. Robba C, Cardim D, Sekhon M, et al. Transcranial Doppler: A stethoscope for the brain-neurocritical care use. J Neurosci Res 2018; 96:720-730.
经颅多普勒：大脑的听诊器 -- 神经重症监护的应用

时域分析方法

• 1. 时域分析方法的定义：时域（time domain）分析方法主要是从序列自相关的角度揭示时间序列的发展规律。
• 2. 时域分析方法的优点：相当于谱分析方法，它具有理论基础扎实、操作步骤规范、分析结果易于解释等优点。目前它已广泛应用于自然科学和社会科学的各个领域，成为时间序列分析的主流方法。
• 3. 时域分析方法的基本思想：事件的发展通常具有一定的惯性，这种惯性用统计的语言来描述就是序列值之间存在着一定的相关关系，而且这种相关关系具有某种统计规律。我们分析的重点就是寻找这种规律，并拟合出适当的数学模型来描述这种规律，进而利用这个拟合模型来预测序列未来的走势。
• 时域很好理解，就是信号随时间的变化。 频域就是自变量是频率，因变量是信号的幅度，也就是通常所讲的频谱图。频谱图描述了信号的频率结构及频率与该频率信号幅度的关系。 空间域又称图像空间 (image space)。由图像像元组成的空间。在图像空间中以长度 (距离) 为自变量直接对像元值进行处理称为空间域处理。 频率域是由时间域求得的，表示相位随时间的变化；波数域是由空间域得来的，表示相位随空间位置的变化。 将空间 - 时间域进行二维傅里叶变换就得到频率 - 波数域。