短暂性脑缺血发作患者证候分类与脑血流的相关性研究

Correlation study of different syndromes and cerebral blood flow in patients with transient ischemic attack

目的探讨短暂性脑缺血发作(TIA)患者不同证候与脑血流的相关性。方法选择TIA患者193例,按中医证候分成风痰内盛、瘀血阻络(BHO)组,肝胆火旺、痰瘀闭阻(HLO)组和气阴两虚、脉络瘀滞(QYC)组3组,并选择51例同期体检的健康人作为正常对照组,3组和正常对照组均应用TCD检测双侧大脑中动脉、大脑前动脉、大脑后动脉和椎基底动脉的血流速度。结果 3证型组各血管血流速度均低于正常对照组;HLO组椎基底动脉和大脑后动脉的血流速度均明显低于BHO组,而与QYC组比较均无显著性差异;大脑中动脉和大脑前动脉的血流速度均明显高于BHO组和QYC组;BHO组椎基底动脉和大脑后动脉的血流速度均明显高于QYC组,而大脑中动脉和大脑前动脉的平均血流速度与QYC组比较均无显著性差异。结论 HLO组主要为椎基底动脉和大脑后动脉缺血;BHO组主要为大脑前动脉和大脑中动脉缺血;QYC组所有脑动脉缺血。

Objective It is to approach the correlation between different syndromes and cerebral blood flow in patients with transient ischemic attack（TIA）.Methods 193 patients with TIA were chosen and divided into blood stasis and hyperactivity of wind-phlegm,obstruction of collaterals by blood stasis group（BHO group）,hyperactivity of fire of liver and gallbladder,obstruction of collaterals by phlegm group（HLO group） and deficiency of both Qi and Yin,collaterals stagnant group（QYC group） according to different syndromes.Meanwhile 51 persons of health examination were as normal control group.The speeds of blood flow of hibateral middle cerebral artery,anterior cerebral artery,posterior cerebral artery and vertebral-basilar artery in the four groups were examined with TCD.Results The speeds of blood flow in the three syndrome groups were all lower than that in normal control group.The speeds of blood flow of vertebral-basilar artery and posterior cerebral artery in HLO group were all obviously lower than that in BHO group but had no significant differences compared with QYC group.The speeds of blood flow of middle cerebral artery and anterior cerebral artery in HLO group were all obviously higher than that in BHO group and QYC group.The speeds of blood flow of vertebral-basilar artery and posterior cerebral artery in BHO group were all obviously higher than that in QYC group.There were no significant differences on the speeds of blood flow of middle cerebral artery and anterior cerebral artery between BHO group and QYC group.Conclusion HLO group has the ischemia of vertebral-basilar artery and posterior cerebral artery.BHO group has the ischemia of anterior cerebral artery and middle cerebral artery.QYC group has the ischemia of all cerebral arterys.