TIA患者CDFI与TCD检查临床分析

Clinical analysis on CDFI and TCD and its risk factors in patients with the transient ischemic attacks

目的探讨短暂性脑缺血发作(transient ischemic attack,TIA)患者血管病变与相关危险因素的关系。方法对207例TIA患者双功能彩色血流影像(color doppler flow imaging,CDFI)及经颅多普勒超声(transcranial cerebral doppler,TCD)结果及危险因素进行回顾分析。结果 TIA患者内膜增厚发生率60.2%,斑块发生率54.1%,以多发斑块(39.1%)和稳定斑块(45.4%)为主,不稳定斑块仅30.4%。血管狭窄发生率47.8%,以多发狭窄(33.8%)和中重度狭窄(30.9%)为主。闭塞发生少(占13.5%)。>60岁组内膜增厚、斑块发生率均高于≤60岁组,P<0.05。有血管狭窄组比无血管狭窄组高密度脂蛋白低,血尿酸及收缩压均高,P<0.05。结论 TIA患者早期动脉硬化表现极为普遍,且随着年龄有增加趋势,血管狭窄与收缩压、血尿酸正相关,与高密度脂蛋白负相关。综合CDFI和TCD有利于血管病变初筛,尽早合理调控血压、血尿酸、血脂防治TIA。

Objective To study the relationship between the risk factors and the cerebral arterial lesions of CDFI and TCD in patients with TIAs.Methods The review of results of CDFI and TCD and risk factors in 207 patients with TIAs were analysed.Results The rate of internal membrane thickening and carotid plaque were 60.2% and 54.1%.They were mostly located near the bifureation and the common carotid artery.There was high percentage of poly and stable plaque.Stenosis incidence was 47.8% while occlusion was only 13.5%.The incidence of internal membrane thickening and carotid plaque was higher in 60 ages than ≤60 ages.There were higher serum uric acid and hypertension level in stenosis group than no stenosis group.But high density lipoprotein cholesterol（HDL-C）level was lower in stenosis group（P〈0.05）.Conclusion The early phase artheroselerosis is very common in TIA and increases with age.Stenosis is positively related with serum uric acid and hypertension.But it is negatively related with HDL-C.CDFI and TCD are helpful in primary examination of TIA.The appropriate treatment of blood lipid,high serum uric acid and hypertension is useful to prevent TIA.