糖尿病及其脑梗死患者脑血管贮备的研究

The study of the cerebrovascular reserve in patients with diabetes or the combined diabetes and cerebral infarction I

目的应用经颅多普勒超声(TCD)屏气试验评价糖尿病(DM)组、高血压动脉硬化腔隙性脑梗死(HALI)组、高血压病(HT)组与糖尿病合并腔隙性脑梗死(DLI)组患者的脑血管贮备(CVR)的关系。方法采用TCD屏气试验对DM组、HALI组、HT组与DLI组各30例患者分别检测屏气前后大脑中动脉(MCA)流速增长的百分数,即屏气指数(BHI)作为CVR的评价指标。结果 DM组与DLI组、DLI组与HALI组、DM组与HT组的BHI及屏气后大脑中动脉血流速度均有统计学差异(P均<0.05)。结论糖尿病合并腔隙性脑梗死比糖尿病,糖尿病比高血压病,糖尿病合并腔隙性脑梗死比高血压动脉硬化腔隙性脑梗死,对CVR的影响更显著。

Objective To assess the association of cerebrovascular reserve（CVR） with diabetes （DM）. hypertensive atherosclerotic lacunar infarction （ HALI）, hypertension （HT） and diabetic lacunar infaretion（DLI） by means of transcranial Doppler ultrasonography （TCD） with breath-holding maneuver. Methods The breath-holding index （BHI）, which was the percentage increase in middle cerebral artery （MCA） blood flow velocity as index of CVR assessment, was detected during breath-holding by TCD and breath-holding technique in 30 diabetic patients, 30 hypertensive atherosclerotic lacunar infarction patients, 30 hypertension patients and 30 diabetic lacunar infarction patients. Results There was significant difference in the ascending rates of Vm and BHI between diabetic group and diabetic lacunar infarction group, diabete lacunar infarction group and hypertensive atherosclerotic lacunar infarction group, hypertension group and diabetic group （all P〈0.05）. Conclusions Diabetes can more significantly impair CVR than hypertension. Diabetic lacunar infarction can more significantly impair CVR than diabetes. Diabetic lacunar infarction can more significantly impair CVR than hypertensive atherosclerotic lacunar infarction .