彩色多普勒超声对大脑中动脉狭窄支架成形术前后血流动力学变化的研究

Study on changes of middle cerebral arterial hemodynamics before and after intraluminal stent-assisted angioplasty in patients with their stenosis by color Doppler ultrasonography

目的探讨大脑中动脉（MCA）狭窄患者行血管内支架成形术治疗前、后血流动力学的变化，评价血管内支架成形术的疗效。方法应用经颅彩色多普勒超声显像（TCCD）观察11例MCA狭窄患者术前狭窄及支架成形术后支架形态，同时检测治疗前、后局部狭窄处及狭窄后血流速度（包括收缩期峰值流速、舒张末流速和平均流速）并行对照分析。结果①11例MCA狭窄患者术后10例支架形态良好，1例伸展未完全。②术前颅内动脉狭窄处局部血流速度明显高于正常，狭窄后血流速度低于正常，差异有统计学意义（P〈0．05）；血管内支架成形术后狭窄处血流速度较术前明显降低，差异有统计学意义（P〈0．05），其中9（／．9％流速恢复正常，1例伸展未完全者略增高，11例患者支架后流速较术前明显增高，差异有统计学意义（P〈0．05），且均恢复正常。结论TCCD可观察MCA狭窄及植入支架的形态，评价MCA狭窄血管内支架成形术治疗前、后颅内动脉血流动力学改变。

Objective To evaluate the changes of middle cerebral arterial （MCA） hemodynamics before and after intraluminal stent-assisted angioplasty for their stenosis. Methods A total of 11 patients with MCA stenosis treated by intraluminal stent-assisted angioplasty were selected. In these cases, their stenosis before treatment and the state of stents after treatment were observed using transeranial color Doppler ultrasonography（TCCD）. Meanwhile, the blood flow velocities （including peak systolic velocity, end diastolic velocity and mean velocity） were measured and studied comparatively at stenosis and post-stenosis place before and after the treatment, respectively. Results ① Among 11 cases implanted stents, 10 stents were in good state after treatment, only one expanded incompletely. ②The blood flow velocities were significantly higher in patients at stenosis place than in normal adults,and lower at post-stenosis place before treatment （ P〈0.05）. The blood flow velocity lowered obviously at stenosis place after treatment （ P 〈0.05） ,among which 90.9% were restored. The one which expanded incompletely was slightly higher. The blood flow velocity increased at post stenosis place after treatment （ P 〈0.05） and all returned to normal. Conclusions TCCD can observe the MCA stenosis and the state of stent,and analyze the changes of their hemodvnamics.