2026-11-092026-11-09https://scholars.csmu.edu.tw/handle/123456789/38652Recent advance in ultrasound technologies (transcranial Doppler) has allowed unprecedented opportunities to study human cerebral hemodynamics in health and disease and to understand the human cerebrovascular regulation. The concept of cerebral critical closing pressure (CrCP) can provide valuable information about the pathophysiologic changes of cerebral circulation and enhance understanding of the mechanisms of cerebrovascular regulation. The CrCP can also be a potential indicator of intracranial pressure. Our previous studies by using custom software to calculate CrCP had demonstrated some limitations of calculation CrCP with noninvasive methods, and the relationship between CrCP and traditional Doppler ultrasound indices during various physiological challenges such as hypocapnia, hypercapnia, straining and orthostasis. Our results also suggested that the CrCP-RAP model has great potential for future studies in evaluating patients and guiding therapeutic interventions. However, the CrCP analysis by using any methods described in the literatures is laborious and time-consuming. Developing a convenient CrCP-analyzing system is demanding for more clinical applications. We thus conduct this 3-year project to develop a real-time CrCP analyzing system modified from our previous off-line analyzing system; to establish a normative database; to compare the CrCP-related indices and current parameters of cerebral vasomotor reactivity including CO2 reactivity, breath-holding index and carotid compression test; to monitoring serial changes of CrCP and other parameters after various pharmacological interventions in head injury patients; and to explore the potential clinical applications in neuro-intensive care.閉鎖臨界壓力為臨床上極具潛力的一個觀念，在我們先前所發表的研究結果顯 示：藉由穿顱超音波所記錄到的血流速度訊號計算求得的腦循環閉鎖臨界壓力，不僅 可以反應腦血管阻力的變化及腦循環調控能力，亦可間接代表顱内壓的變化。但截 至目前為止，關於腦循環閉鎖臨界壓力的相關臨床文獻仍極為有限，推究其原因可 能因為現有的文獻資料均屬事後再行分析之研究，其分析之結果無法快速、方便地 獲得，故其臨床上的應用便受到相當的限制。 為此我們設計本3年期的計劃，在第一年計劃中，我們將根據先前在研發腦循 環閉鎖臨界壓力分析系統過程中的心得，將此一系統進一步改良，使其具有可以即 時計算腦循環閉鎖臨界壓力，並記錄、分析其變化趨勢的功能；在此過程中，並測 試與驗證這個系統所求得數據的正確度，逐步改良其可近性與可用性。在第2年的 計劃中，我們將比較由我們的系統所計算出的各種閉鎖臨界壓力相關參數，與傳統 腦循環調控功能測試的代表參數如：二氧化破的反應性，閉氣測試(breath-holding index)、與頸動脈壓迫(carotid compression test)等，評估各種參數之間的相關性，並 藉由比較正常人與頸動脈狹窄患者之間表現的異同，嘗試找出與臨床疾病嚴重度相 關性較佳之參數。第3年的研究，則計劃將在實驗室中使用的系統，略加修正、整 合成一可攜式的系統，進一步應用於加護中心或病房中，無法移動之重症或行動不 便的急性頭部外傷或腦梗塞患者，監測其在接受臨床處置如：昇血壓劑、高張食鹽 水、降腦壓製劑、過度換氣等情況下，腦循環閉鎖臨界壓力與各種生理參數之變化， 並進一步分析這些參數變化與臨床病況及預後的關係。 本計劃將建構一開放之即時分析系統，以提供臨床醫師在評估與處置患者時， 及時而有效之指標，並有潛力可提供相關領域研究的平台。腦循環調控閉鎖臨界壓力穿顱超音波cerebrovascular regulationcritical closing pressuretranscranial DopplerProject