健康体检中高血压患者经颅多普勒检测与临床分析

TCD inspection and clinical analysis of hypertension patients in health examination

目的：研究健康体检中对高血压患者脑底动脉环经颅多普勒（TCD）检测的应用。方法：选择2010年1月~2011年1月在我院体检科进行健康体检中血压增高者1 055例（观察组）,回顾性分析其TCD检测结果及相关临床资料（年龄、性别、临床诊断、遗传病史等）,同时按年龄分层抽取同期行TCD检测的血压正常者1 744人作为对照组。研究TCD改变与临床的关系,为高血压患者的脑血管功能学评价提供客观血流动力学资料。结果：进行TCD检查的1 055例被检者中,动脉硬化518例;颈内动脉系统单支或多支血管收缩期血流速度增高703例,其中,涡流及湍流54例;收缩期血流速度减低16例;椎基底动脉系统收缩期血流速度增高599例,收缩期血流峰速度减低8例。与对照组相比,观察组脑动脉硬化频谱（χ2=738.000,P〈0.001）、颈内动脉收缩期血流速度（χ2=337.700,P〈0.001）、涡流及湍流的改变（χ2=21.687,P〈0.001）差异有高度统计学意义,提示观察组上述检测项异常率显著增高;多支血管异常改变（856例）多于单支血管（30例）;TCD检测异常率（83.981%）高于被检者对相关疾病的知晓率（26.437%）。结论：TCD检测可较灵敏地反映高血压时脑血管的血流动力学改变,对血压增高者的脑血管功能学评价及指导临床预防和治疗具有重要意义,在高血压病的健康管理中可发挥作用。

Objective： To investigate the TCD inspected application of cerebral arterial circle of hypertension patients in health examination.Methods： 1 055 hypertension patients in department of health examination in our hospital from January 2010 to January 2011 were selected as observation group,and their TCD inspected results and clinical data including of age,gender,clinical diagnosis and genetic disease were reviewed retrospectively.Meantime,1 744 cases with normal blood pressure were selected as control group which was stratified by age over the same period.The relationship between the changing of TCD and clinical situation was studied to provide an objective data of hemodynamics to the appreciation of cerebrovascular function in hypertension patients.Results： In the 1 055 hypertension patients,there were 518 patients with arteriosclerosis;703 patients with single artery or multi artery of internal carotid artery system blood flow velocity upgrade in systole period,and 54 patients with eddied flow or turbulent flow,16 patients with blood flow velocity downgrade in systole period;599 patients with vertebral basilar system blood flow velocity upgrade in systole period,and 8 patients with downgrade phenomenon.Compared with control group,the changing of the spectrum of cerebral arteriosclerosis（χ2=738.000,P〈0.001）,the speed of blood flow of internal carotid artery in systole period（χ2=337.700,P〈0.001） and eddied flow or turbulent flow（χ2=21.687,P〈0.001） of observation group were all with statistical significance,all of these above signified the inspected items upgrade significantly in observation group.Multi arteries abnormally changing had a higher frequency than single artery.The rate of TCD inspection with abnormality was higher than the rate of the patients with the knowledge of the relevant diseases.Conclusion： TCD inspection could demonstrate the hemodynamics changing of cerebral vessels in hypertension period sensitively,and TCD inspection also has important meaning to evaluate the function of cerebral vessels in hypertension patients,guide the clinical prophylaxis and clinical treatment.TCD can produce a marked effect in health management of hypertension.