经颅多普勒超声检测老年人糖尿病脑血管病变

Trauscranial Doppler ultrasonic examination of aged diabetics with cerebral vascular diseases

目的为了解老年人高血压和糖尿病对脑血管病变的影响，探讨老年人糖尿病脑血管病变经颅多普勒超声的诊断方法。方法对老年人糖尿病并存高血压、糖尿病或高血压患者及健康对照组共１０５０条、老年前期各组共１３９５条脑血管进行了经颅多普勒超声检查及对照分析。结果老年患者中以糖尿病并高血压组呈现血流缓慢供血不足型异常最多见，占该组受检血管的８．９％；老年前期组中糖尿病并高血压组及单纯糖尿病组的发生率也较单纯高血压组为高，三者分别为４．６％、６．０％和０．７％。结论老年人高血压、糖尿病并存时脑血管血流缓慢供血不足病变最常见，对发生脑梗塞的患者进行经颅多普勒超声动态观察殊为必要。

Objective To understand the influence of ageing hypertension and diabetes mellitus(DM) on cerebral vascular diseases and study the transcranial Doppler ultrasonic(TCD) diagnostic method for the aged diabetics with cerebral vascular diseases.Metbods TCD examination was performed in aged and preaged.The aged group included 18 diabetics with hypertension, 12 with only DM, 25 with only hypertension and 15 normal controls,totaled up to 1 050 cerebral arteries.The preaged group included 13 diabetics with hypertension,10 diabetics without hypertension,27 with only hypertension and 43 normal controls,a total of 1 395 cerebral vascular arteries was examined.Results Arterial insufficiency with slowed blood flow happened most frequently in aged diabetics with hypertension, accounted 8.9% of the examined arteries in the aged group.In the preaged group arterial insufficiency with slowed blood flow was more frequently seen in both diabetics with and without hypertension than in non-diabetics with only hypertension.The arterial insufficiency rate in the three groups was 4.6%,6.0% and 0.7% respectively.Conclusions These results suggest that the coexistence of senility,hypertension and DM may induce more cerebral vascular diseases.Furthermore,due to the weakening or disappearance of the signals of TCD in diabetics suffering from cerebral infarct,there is obvious lowering of the detecting rate of cerebral arteries.Under such circumstances, it is necessary to follow-up these patients by TCD.