脑出血患者脑血流速度的观察

Study on the cerebral blood flow velocity in patients with cerebral hemorrhage

目的 观察脑出血后脑主要动脉的血流速度变化,进而研究脑血流动力学变化的临床价值。方法 采用经颅超声多普勒(transcranial Doppler,TCD)分别对216例脑出血患者和80名健康对照者的大脑中动脉、大脑前动脉、大脑后动脉、颈内动脉、基底动脉和椎动脉等颅内主要动脉的血流速度进行检测分析,记录包括收缩期峰速(Vs)、舒张期末流速(Vd)及搏动指数(PI)等血流参数及频谱形态。结果 脑出血组患者收缩期峰速与舒张末期流速与对照组比较均降低,差异有显著性意义(P<0.001)。脑出血组有164例患者(7.93％)颅内动脉血流速度降低,其中51例(23.61％)发生于脑出血早期,以舒张期末流速降低为主,113例(52.31％)发生于脑出血的中、后期,表现为普遍性流速降低。另有52例(24.07％)脑血流速度基本正常。结论 多数脑出血患者脑组织处于低循环状态,其程度与病情相关,因此对脑出血患者进行血流动力学监测有助于指导治疗及判断预后。

Objective The blood flow velocity changes of main intracranial arteries, and the clinical estimation of the intracranial hemodynamic changes after cerebral hemorrhage were studied. Methods The blood flow rate of main intracranial arteries including middle cerebral artery, anterior and posterior cerebral artery, basilar and vertebral artery of 216 patients with cerebral hemorrhage and 80 healthy controls were ex-aminated by transcranial Doppler (TCD) ultrasound technique. The data of peak systolic velocity (Vs), end di-astolic velocity (Vd) and pulsation index (PI) were recorded. Results The Vs and Vd in patients with cerebral hemorrhage were less than that in controls with significant difference (P<0.01). The decrease of intracranial arterial blood flow velocity was found in 164 patients (75.93%) with cerebral hemorrhage. Among them the decrease were mainly in Vd and occurred at the early stage of hemorrhage in 51 cases (23.61%), the general decrease were found in intermediate and late period of hemorrhage in 113 cases (52.31%). Conclusion It is demonstrated that the most cerebral hemorrhage patients were in the state of low cerebral circulation, its degree is positively correlated with the intensity of the disease. Thus it is helpful for guiding the therapeutic approach and predicting the prognosis.