老年冠心病患者脑血管病变经颅多普勒超声观察

An observation on changes of cerebral arteries by transcranial Doppler ultrasonography in aged patients with coronary artery disease

目的了解老年冠心病患者脑血管病变情况，探讨经颅多普勒超声（ＴＣＤ）在老年冠心病患者脑血管病变辅助检查中的作用。方法对５２例经选择性冠状动脉造影确诊的老年冠心病患者作ＴＣＤ检查，观察主要大中型脑动脉的平均血流速度（Ｖｍ）、搏动指数（ＰＩ）、阻力指数（ＲＩ）和狭窄情况，并与３０例健康老年人对比分析。结果冠心病患者各脑动脉的ＰＩ和ＲＩ均较健康人明显增加（Ｐ＜０．０１），Ｖｍ均较健康组明显减慢（Ｐ＜０．０５），脑动脉狭窄发生率明显高于健康人（Ｐ＜０．０１）。随着冠状动脉病变支数的增多，脑动脉的ＰＩ和ＲＩ相应增大（Ｐ＜０．０５），脑动脉狭窄的例数有增多的趋势。结论老年冠心病患者常伴有脑血管病变，ＴＣＤ是一种简便且有价值的检查方法。

Objective To observe changes of cerebral arteries in aged coronary artery disease (CAD) patients. Methods Transcranial Doppler ultrasonography (TCD) was performed in 52 old CAD patients confirmed by coronary angiography and 30 healthy old subjects. Mean velocity (Vm), pulsatility index(PI), resistant index (RI) and the rate of stenosis of main medium large cerebral arteries were obtained. Results To compare with the healty control, PI and RI of all cerebral arteries were significantly increased ( P <0 01),but Vm were decreased ( P <0 05) in CAD patients. The rates of stenosis of cerebral arteries in CAD patients were higher than in healthy control ( P <0 01). As coronary atherosclerosis progressed, cases of stenosis of cerebral arteries were also increased. Conclusions Old CAD patients usually have cerebral vasculer disease. TCD is a simple and valuable method of examination.