脑梗死患者血流动力学的季节性变化

Seasonal variation of hemodynamics in patients with cerebral infarction

目的应用经颅多普勒(TCD)探讨季节变化对脑梗死患者颅内血流动力学的影响。方法对脑梗死组和对照组进行TCD检测,冬季检测一次,夏季复检一次,观察双侧大脑中动脉(MCA)的收缩期峰值血流速度(Vs)、舒张末期血流速度(Vd)、平均血流速度(Vm)、搏动指数(PI)的变化特征,对两组在不同季节的TCD血流指标改变进行统计学分析。结果①脑梗死组与对照组的PI值冬夏季差异均有统计学意义(P<0.001),脑梗死组PI值均高于对照组;②两组冬夏季血流指标自身比较差异均无统计学意义(P>0.05);③脑梗死组中进展组的Vs在不同季节差异有统计学意义,冬季Vs明显比夏季慢;④脑梗死组各危险因素分组中,MCA狭窄组的Vs、Vm在不同季节差异有统计学意义,冬季Vs、Vm均高于夏季;高血压组、血脂异常组、NIHSS评分分组在冬夏季差异无统计学意义。结论季节变化与脑梗死患者颅内血流动力学改变有相关性,有MCA狭窄的脑梗死患者脑血流动力学改变更易受寒冷刺激影响。

Objective To investigate the effect of seasonal variation towards hemodynamic in patients with cerebral infarction.Methods Transcranial Doppler was performed in cerebral infarction and control groups,which examined in winter and re-examined in summer.The variation of systolic velocity（Vs）,diastolic velocity（Vd）,mean velocity（Vm）,pulsatility index（PI） of bilateral middle cerebral artery were observed,and then the two groups＇ blood flow index change in different season were analyzed.Results Between cerebral infarction group and control groups,the variation of PI was statistical significance.（Neither in winter nor in summer,P0.001）,PI in winter was higher then in summer.Nither cerebral infarction group nor control group,the variation of blood flow index had no statistical significance in different season（P0.05）.The variation of Vs in progress group had statistical significance in different season,Vs was obviously slower in winter then in summer.Among the risk factors of cerebral infarction,the variation of Vs and Vm in MCA stenosis group were statistical significance,both of them were higher in winter then in summer.However,the variation among hypertension,dyslipidemia,and NIHSS groups had no statistical significance.Conclusions Seasonal variation is significantly associated with hemodynamic chang in cerebral infarction.The patient with MCA stenosis is more susceptible to cold stimulation.