高原头痛头昏与脑血流改变的关系

RELATIONSHIP BETWEEN HEADACHE-VERTIGO AND CHANGES IN CEREBRAL BLOOD FLOW AT HIGH ALTITUDE

在西藏山南(3600m)观察了高原头痛、头昏的发生情况和与脑血流的关系。结果表明,快速进驻高原和久居高原人头痛、头昏的人数均达一半以上,快速进驻高原头痛、头昏者的脑血流图(REG)主峰波幅、流入容积速度和上升角明显高于无症状者。久居高原头痛、头昏者的REG主峰波幅明显高于无症状者,流入容积速度和上升角明显小于无症状者。提示高原急、慢性缺氧头痛、头昏的原因不同,急性缺氧头痛、头昏同脑血流过度增加有关;慢性缺氧头痛、头昏主要同脑血管的顺应性降低、脑血流减少有关。

Subjects were divided into acute hypoxia and chronic hypoxia groups to evaluate the relationship between headache-vertigo and cerebral blood flow (CBF). CBF was measure by means of rheoencephalograghy (REG). Diagnosis of headache-vertigo was established by the method of symptom questionaire. CBF was also observed in normal native subjects (middle school students of local Tibetan resident and 1 year resident PLA men) at the same altitude. The results showed that headache-vertigo appeared in more than 5of the subjects of both acute and chronic hypoxia groups. In the acute hypoxia group, the amplitude of systolic wave, inflow volume velocity and rising angle of REG in the subjects with headache-vertigo were higher than those without the symptom, while in the chronic hypoxia group, we observed higher amplitude of systolic wave but lower inflow volume velocity and smaller rising angle in the subjects with the symptom (as compared with those without the symptom). Values of REG parameters of the symptomless subjects of chronic group were similar to those of normal subjects. The results suggest that headache-vertigo is correlated with excessive increase of GBF during acute hypoxia, but associated with a decrease of CBF during chronic hypoxia exposure.