癫痫亚临床发作的脑血流动力学监测

Haemodynamic monitoring by transcranial Doppler in sub-clinical epilepsy attack

目的:探讨癫痫亚临床发作过程中脑血流动力学监测的价值。方法:对30例癫痫亚临床发作患者同步进行经颅多普勒及脑电图连续监测,对发作前1min及发作后1、5、10和20min的监测资料进行分析。结果:经重复测量数据的方差分析,癫痫亚临床发作前后大脑中动脉的收缩期峰血流速度、平均血流速度、舒张期末血流速度、搏动指数及心率差异均有统计学意义(F=69.880、78.716、58.393、119.209和164.268,P均<0.001),与发作前比较,发作后1min收缩峰血流速度、平均血流速度、舒张期末血流速度及心率最快(P均<0.001),搏动指数最低(P<0.001)。结论:癫痫亚临床发作时脑血流动力学有其独特的规律,经颅多普勒监护显示脑血流速度突然增快提示癫痫亚临床发作。

Aim：To investigate the value of transcranial Doppler（TCD）in haemodynamic monitoring of sub-clinical epilepsy.Methods：Thirty patients with sub-clinical epilepsy were continuously monitored by TCD and electroencephalogram（EEG）.TCD data of five time points were analyzed,including 1 min before sub-clinical epilepsy attack,1,5,10,and,20 min after sub-clinical epilepsy attack.Results：There were significant differences of systolic velocity（vs）,mean velocity（vm）,diastolic velocity（vd）,pulsatility index（PI）of middle cerebral artery（MCA）and heart rate（HR）between pre-and post-sub-clinical epilepsy（F=69.880,78.716,58.393,119.209,and 164.268,P〈0.001）.vs,vm,vd and HR reached the peek（P〈0.001）,and PI was lowest 1 min after sub-clinical epilepsy attack（P〈0.001）.Conclusion：There is typical haemodynamic change during sub-clinical epilepsy attack.Abrupt increase of cerebral blood flow in TCD shows that there will be sub-clinical epilepsy attack.