高血压患者的经颅多普勒超声检测结果分析

Analysis of results of transcranial doppler ultransound in patients with hypertension

目的应用经颅多普勒超声(TCD)探讨高血压病各期患者颅内动脉血流动力学改变,评价经颅多普勒对高血压病的诊断价值。方法利用TCD技术检测196例高血压患者的脑动脉(颈内动脉系统及椎-基底动脉系统)血流的改变及频谱的形态,分析其脑动脉血流各项指标变化。结果 196例高血压患者中180例可见一支或数支血管的改变,高血压各组TCD总异常率91.8%。196例高血压患者中脑血管痉挛病例93例,占总病例数47.4%;脑供血不足病例69例,占总病例数35.2%;18例脑血管狭窄,占总病例数9.2%;脑动脉硬化118例,占总病例数60.2%。Ⅱ期和Ⅲ期高血压患者的脑血流异常率(分别为93.4%,100%)显著高于Ⅰ期高血压病例(83.0%,P均<0.01);Ⅱ期和Ⅲ期高血压脑血流异常率无统计学意义(P>0.05),但异常血流变化的比较差异有统计学意义(P均<0.01)。结论 TCD可反映高血压患者颅内动脉病变程度,判断血管弹性及血流动力学变化,为临床提供有价值诊断依据。

Objective To investigate the hemodynamics change of intracranial artery in patients with hypertension,and the value of transcranial Doppler（ TCD） in the diagnosis of hypertension. Methods TCD was performed in 196 cases of hypertension to measure the changes in blood flow and shape of the spectrum in cerebral arteries（ internal carotid artery system and vertebrobasilar system）. Results 180 in 196 patients were with lesions in one or more vessels with a total rate of 91. 8%. 93 cases（ 47. 4%） were with cerebral vasospasm,69 cases（ 35. 2%） with cerebral blood insufficiency,18 cases（ 9. 2%） with cerebrovascular stenosis,and 118 cases（ 60. 2%） with cerebral arteriosclerosis. The abnormal ratio of cerebral blood flow in stage II and III hypertension（ 93. 4%,100%） was significantly higher than stage I hypertension（ 83. 0%,P〈0. 01）; no significant difference in abnormal ratio was found between stage Ⅱ and Ⅲ hypertension（ P〈0. 05）,but the abnormal hemodynamic changes were significant statistical significance between them（ P〈0. 01）. Conclusion TCD can reflect the degree of intracranial arterial lesions in patients with hypertension,determine the vascular elasticity and blood flow status,provide the basis for clinical diagnosis.