彩色多普勒超声分析缺血性脑血管病患者颈内动脉狭窄血流动力学改变的临床价值

Analysis on hemodynamic changes of the internal carotid artery stenosis in patients with ischemic cerebral vascular disease

目的应用彩色多普勒超声(CDUS)分析缺血性脑血管病(ICVD)患者颈内动脉狭窄血流动力学改变的临床价值。方法对50例健康成人和48例ICVD患者,常规行颈动脉彩色多普勒超声检查,通过二维灰阶超声检查(2D)、彩色多普勒血流成像(CDFI)计算颈内动脉(ICA)最狭窄处直径狭窄率,脉冲多普勒(PD)测量颈动脉收缩期峰值流速(PSV)、舒张末期流速(EDV)、阻力指数(RI),计算ICA与颈总动脉(CCA)收缩期峰值流速比值(ICA-PSV/CCA-PSV)。诊断ICA狭窄程度与磁共振血管成像(MRA)进行对比。结果 ICA组ICA-PSV、ICA-PSV/CCA-PSV与对照组无明显差异(P>0.05);ICA-EDV明显低于对照组(P<0.05),而RI明显高于对照组(P<0.05)。本研究诊断ICA中、重度狭窄和闭塞的结果 ,与MRA诊断结果比较无明显统计学差别(χ2=0.1557,P>0.05)。结论 CDUS通过ICA血流动力学变化反映脑血管病变,有助于ICVD的鉴别诊断及预后判断,为早期采取有效的预防和治疗措施提供依据。

Objective The clinical value of Color Doppler ultrasound(CDUS)in researching the hemodynamic parameters of the internal carotid artery stenosis in patients with ischemic cerebral vascular disease(ICVD).Methods The study was consisted of 50 normal adults and 48 patients with ICVD.Using Color Doppler ultrasound(CDVS)to exam carotid artery,the diameter stenosis rate of ICA was calculated using the special software in the work station of the machine.Parameters of carotid artery were measured,including peak systolic velocity(PSV),end-diastolic velocity(EDV),and resistance index(RI).The PSV ratio of ICA and common carotid artery(CCA)were calculated.The results of our research were compared with magnetic resonance angiography(MRA)findings in diagnostic criterion of ICA stenosis.Results The parameters of tests including ICA-PSV and ICA-PSV/CCA-PSV in patients with ICVD and the healthy controls,there were no significant difference(P>0.05).ICA-EDV in patients with ICVD was significantly lower than the healthy controls(P0.05).Conclusion The blood flow spectrum changes of ICA by CDUS could contribute to the differential diagnosis and predicting prognosis of ICUD.It is valuable to take early and effective measures for the prevention and treatment of anterior circulation ischemic stroke.