症状性椎基底动脉狭窄患者后循环微栓子检测及随访

Post Cyclic Microembolic Signals Detection and follow-up in Ischemic Stroke Patients with Symptomatic Vertebral-basilar Artery Stenosis

目的:探讨症状性椎基底动脉狭窄患者后循环中微栓子监测的临床价值。方法:收集本院神经内科住院的75例急性缺血性中风合并椎基底动脉狭窄患者进行经颅多普勒(TCD)检查及脑微栓子检测,随访观察数据之间行配对t检验。结果:75例患者中MES阳性13例,阳性率17.3%,中高度狭窄组患者阳性率明显高于轻度狭窄患者(25.0%vs6.5%,P<0.05);抗栓治疗后MES明显减少;73例患者随访,12例(12/73,16.4%)缺血性中风再发,MES阳性缺血性中风复发率高于MES阴性组(38.5%vs11.7%,P<0.05)。结论:可以通过大脑后动脉(posterior cerebralartery,PCA)和基底动脉(basilarartery,BA)进行微栓子监测,评价抗栓治疗的疗效,中高度狭窄的椎基底动脉更易出现后循环的MES;后循环MES阳性的患者易复发脑卒中。

Objective： To study clinical value of detecting post cyclic microemboli Signals in Ischemic Stroke patients with symptomatic vertebral-basilar artery stenosis. Methods： Transcranial Doppler souography （TCD）and the detecting cerebral microemboli signals （MES） were performed in Ischemie Stroke patients （75 cases） with symptomatic vertebral-basilar artery stenosis. Results： The positive rate of MES was 17.3% （ 13/75 ） , The positive rate of MES was higher in medium-high grade vertebral-basilar artery stenosis group than that in low grade stenosis group （ 25.0% , 6. 5%, P 〈0.05） ,anti-platelet agents reduced MES, 73 follow-up patients, ischemic event recurred in 12 cases, The rate of ischemic event recurrence in the MES group was higher than that in the MES negative group（38.5%, 11.7%, P 〈 0.05）. Conclusions ： The MES in the posterior cerebral artery and the basilar artery can be detected, it can be used to evaluate the anti-embolism therapeutic effect. The MES have higher occurrence in patients with medium-high grade vertebral-basilar artery stenosis, the patients with the posterior cycle MES have the higher risk of ischemic event recurrence.