经颅多普勒在2型糖尿病并发脑梗死的临床应用

The clinical application of transcranial Doppler(TCD) in type 2 diabetes patients with cerebral infarction

目的探讨经颅多普勒(TCD)对2型糖尿病(T2DM)患者并发脑梗死的临床应用价值。方法对65例T2DM合并脑梗死,58例T2DM无并发症患者及60例年龄和性别相匹配的健康人进行TCD检测,检测大脑中动脉(MCA)、颈内动脉颅外段(ICA)、基底动脉(BA)的收缩峰血流速度(Vs)、舒张末期血流速度(Vd)、平均血流速度(Vm)、脉动指数(PI)。各参数的结果作比较分析。结果T2DM合并脑梗死组MCA、ICA、BA的Vm和Vs均高于T2DM无合并症组和对照组(P<0.01),尤以Vs增快显著。T2DM合并脑梗死组各检测动脉的PI值均明显高于T2DM无并发症组和对照组(P<0.01)。结论PI、Vs对糖尿病脑血管病变有良好的敏感性,TCD检测对预测和预防糖尿病缺血性脑血管病发生,判断预后,指导早期治疗,预防脑梗死发生具有重要作用。

Objective To investigate the application of TCD in type 2 diabetes with cerebral infraction. Methods TCD was used to measure the systole blood flow velocity （ Vs ） ,the dilating blood flow velocity （Vd） ,the mean blood flow velocity （ Vm）and pulsatility index （PI） of middie cerebral artery （ MCA ）, the extracranial internal carotid artery （ ICA ） and basilar artery （BA） in type 2 diabetes with cerebral infarction （ 65 cases ）, diabetes without complication（ 58 cases） and age , gender matched healthy controls （60 cases）. Each parameter were analyzed respectively. Results The Vm and Vs of MCA. ICA. BA were significantly higher in diabetic patients with cerebral infraction than those diabetic patients without complication and healthy controls（ P 〈0.01 ）. The Vs had abnormal increase is obviously. The Pls of arteries in diabetes with cerebral infarction were significantly higher in diabetic patients with cerebral infraction than those diabetic patients without complication and healthy controls （ P 〈 0.01 ）, Conclusion It indicated that PI and Vs might be two useful markers for the detection of diabetic cerebrovascular changes, TCD can be used to predict cerebral infarction in type 2 diabetes patients ,and calculate the effects after cure, Guide cure in early days ,prevent brain from stroke have import function.