大面积与腔隙性脑梗死经颅多普勒超声血流动力学分析

Hemodynamic analysis of transcranial doppler ultrasonography in massive and lacunar cerebral infarction

目的:应用经颅多普勒超声(TCD)监测大面积脑梗死与腔隙性脑梗死血流动力学变化,并进行相关性分析。方法:选择2009年2月至2012年5月在广东省揭阳市人民医院及广州医学院附属第二医院收治的80例脑梗死患者作为研究对象,其中大面积脑梗死40例(A组)、腔隙性脑梗死40例(B组),选择同期正常(C组)36例作为对照。应用TCD进行脑血管血流动力学监测。结果:A组脑血流异常率为95%(38/40);B组脑血流异常率为75%(30/40);C组脑血流异常率为33%(12/36);A组血流异常率明显高于B、C组,差异有统计学意义(P<0.05),B组血流异常率明显高于C组(P<0.05)。A、B、C组脑血管狭窄患者分别为21、17、2例,A组、B组血管狭窄率较C组明显增多(P<0.05)。A组、B组流速减慢发生率较C组增多(P<0.05)。A组脑梗死病灶侧MCA、ICA、ACA的PI、RI较B、C组明显增大(P<0.05)。结论:应用TCD有助了解大面积脑梗死患者颅内血管血流动力学情况,为治疗、判断病情及预后提供参考依据,也可作为常规的脑血管病的排查手段。

Objective： To investigate the changes in hemodynamics of transcranial doppler （TCD） uhrasonography in massive and lacunar cerebral infarction, thus allowing subsequent correlation analysis. Methods： Eighty patients with cerebral infaretion who were admitted to Guangdong Jieyang People＇s Hosptial and The Second Affiliated Hospital of Guangzhou Medical College between February 2009 and May 2012 were allocated to massive cerebral infarction group （group A, n = 40） and lacunar cerebral infarction group （group B, n = 40）. A total of 36 patients who were simuhaneously admitted to the department of neurology were enrolled as control group. TCI） was employed to conduct hemodynamie monitoring on the cerebral vessels. Results： The rate of aberrant hemodynamic was the highest （95%, 38/40） in group A, followed by 75% （30/40） in group B and 33% （12/36） in group C （ P 〈 0.05 for among-group comparison, and between group B and group C）. Group C had a lower number of patients with vascular stenosis （2 vs. 21 and 17） and reduced blood flow than groups A and B （ all P 〈 0.05 ）. Group A showed significantly increased PI and RI of MCA, ICA and ACA at the affected side compared with groups B and C （all P 〈 O. 05 ）. Conclusion： TCD may facilitate detection of intracranial hemodynamie and offer rationale for treatment decision-making, assessment of the conditions and prognosis in patients with massive cerebral infarction, and could be regarded as the routine for screening cerebral vascular diseases.