经颅彩色多普勒超声评价强化他汀类药物对高海拔地区无症状大脑中动脉狭窄患者的疗效及对血流动力学的影响

The Effect of Intensive Statins on the Treatment of Asymptomatic Middle Cerebral Artery Stenosis and Cerebral Hemodynamics by Transcranial Color Doppler Ultrasound at High Altitude

目的:通过经颅彩色多普勒超声(TCCD)评价强化他汀类药物对高海拔地区无症状大脑中动脉狭窄患者的疗效及对脑血流动力学的影响。方法:收集西宁地区60例经TCCD筛查的无症状大脑中动脉狭窄患者,且经CT血管造影术(CTA)进一步明确诊断,根据患者是否规律服用强化他汀类药物分为服药组和对照组,治疗前通过TCCD检查无症状大脑中动脉狭窄患者的脑血流动力学参数,治疗6个月后再次行TCCD检查。结果:服药组大脑中动脉狭窄转归比例高于对照组(P<0.05)。服药组重度狭窄逆转情况优于对照组(P<0.05)。治疗后,服药组低密度脂蛋白(LDL-C)、胆固醇(TC)及甘油三酯(TG)水平均明显低于治疗前及对照组(P<0.05)。治疗后,两组患者平均血流速度(Vm)、收缩期血流速度(Vs)、舒张期血流速度(Vd)均低于治疗前(P<0.05),搏动指数(PI)高于治疗前(P<0.05),且服药组优于对照组(P<0.05)。结论:高海拔地区强化他汀类药物不仅能降低无症状大脑中动脉狭窄患者血脂水平,还能促进大脑中动脉狭窄的转归,改善脑血流动力学参数。

Objective:This study is to evaluate the effect of intensive statins on the treatment of asymptomatic middle cerebral artery stenosis and cerebral hemodynamics by transcranial color Dopplerultrasound(TCCD)at high altitude.Methods:60 asymptomatic patients with middle cerebral artery stenosis screened by TCCD in Xining area were collected and further diagnosed by CTA.The patients were divided into drug taking group and control group according to whether they regularly took intensive statins.The cerebral hemodynamic parameters of asymptomatic patients with middle cerebral artery stenosis were examined by TCCD before treatment,and TCCD was performed again 6 months after treatment.Results:The incidence of middle cerebral artery stenosis in the drug group was higher than that in the control group(P<0.05).The reversion of severe stenosis in the medication group was better than that in the control group(P<0.05).After treatment,the levels of LDL-C,TC and TG in the treatment group were significantly lower than before treatmentand thosein the control group(P<0.05).After treatment,the average blood flow velocity(Vm),systolic blood flow velocity(Vs)and diastolic blood flow velocity(Vd)of the two groups were lower than before treatment(P<0.05),and the pulsatility index(PI)was higher than before treatment(P<0.05),and the drug taking group was better than the control group(P<0.05).Conclusion:Intensifying statins at high altitude can not only reduce the blood lipid level of asymptomatic ICAS patients,but also promote the outcome of middle cerebral artery stenosis and improve cerebral hemodynamic parameters.