自发性蛛网膜下腔出血后脑血管痉挛节律特征的研究

Study of rhythmical characteristic for cerebral vasospasm after spontaneous subarachnoid hemorrhage

目的:探讨分析自发性蛛网膜下腔出血后脑血管痉挛的生物节律特征。方法:选取87例经头颅CT、CTA、DSA及脑血管彩超确诊为蛛网膜下腔出血并发脑血管痉挛患者,在自然光暗循环条件下利用经颅多普勒(Transcranial Dopplor,TCD)对患者大脑中动脉平均血流速度(Vm)进行24小时以上连续监测后判断分析24小时12个时间段的发病时间特征。结果:8∶00点和20∶00点两个时间点的大脑中动脉平均血流速度较其他时间点有显著性差异,流速显著较快(P<0.05),脑血管痉挛的节律变化特征呈"双峰"表现。结论:自发性蛛网膜下腔出血后脑血管痉挛时间具有典型的近日节律特征,其发病高峰期位于每日的8∶00点及20∶00点。

Objective： Characteristics of biological rhythms for cerebral vasospasm after spontaneous subarachnoid hemorrhage were analyzed. Methods. 87 cases of subarachnoid hemorrhage complicated with cerebral vasospasm were selected, which were definitively diagnosed by cranial CT, CTA, DSA and cerebral vascular ultrasound. Middle cerebral artery mean blood velocity （Vm） was detected consecutively by transcranial Doppler （Transcranial Dopplor, TCD） in the natural light-dark cycle. Characteristics of 12 time-points when SAH was onset were analyzed. Results; Vm at Two time-points, 8 ： 00 and 20 ： 00, were significant difference （P〈0. 05） and these two mean Vm were faster than others. The feature of cerebral vasospasm circadian rhythm was bimodal. Conclusion： Spontaneous subarachnoid hemorrhage vasospasm time has typical circadian rhythms and peak incidences in the daily were at 8： 00and20：00.