肺炎衣原体感染对急性脑梗死患者脑血流动力学的影响

The cerebral hematological changes in acute cerebral infarction patients infected with Chlamydia pneumoniae

目的探讨肺炎衣原体(CPn)感染的急性脑梗死患者脑血流动力学变化情况。方法对有CPn慢性感染的121例急性脑梗死患者作为观察1组和有CPn急性感染的25例急性脑梗死患者作为观察2组进行经颅多谱勒超声检查,并与同期非CPn感染的39例急性脑梗死患者(对照组)进行对比分析。结果观察1组中颅内血流动力学异常的血管有3支和3支以上的患者明显少于观察2组和对照组(均P<0.01),供应梗死病灶的主要血管的平均峰流速度低于对照组(P<0.05),而阻力指数和脉动指数均高于观察2组和对照组(均P<0.05),尤其大脑中动脉和基底动脉。结论CPn慢性感染的急性脑梗死患者脑血管病变虽不如非CPn感染的急性脑梗死患者广泛,但其梗死区供血血管不仅血流慢,且阻力高和弹性差。

Objective To explore the impact of Chlamydia pneumoniae infection on cerebral hemodynamics changes in acute cerebral infarction patients, Methods Transcranial doppler ultrasonography was used for determination of cerebral hemodynamics parameter in 121 acute cerebral infarction patients infected with Chlamydia pneumoniae （ the first experiment group）, Meanwhile the same parameters in 25 acute cerebral infarction patients acutely infected with Chlamydia pneumoniae were measured （ the second experiment group） and 39 acute cerebral infarction patients without Chlamydia pneumoniae infection （ the control group） were taken as control. Results The patients with three or over three abnormal cerebral hemodynamics vessels in the first experiment group were obviously less than that of the second experiment group and the control group （ P 〈 0,01 ）, But the mean peak flow velocity was lower in the first experiment group than in the control group （ P 〈 0.05）. the resistance index and the pulsation index of the primary vessel supplying infarct focus were obviously higher in the second experiment group and the control group （ all P 〈 0.05）. Conclusion Although the pathological changes of cerebral vessel in acute cerebral infarction patients infected with chronic Chlamydia pneumoniae is not as wide as in acute cerebral infarction patients without infected with Chlamydia pneumoniae, but the blood flow velocity of the primary vessel supplying infarct focus is slow, the resistance index high and the arterial elasticity is inferior.