双侧脑动静脉间脉搏波传导时间对腔隙性脑梗死的初步评价及与颈动脉硬化相关性分析

A preliminary study on the relationship between bilateral lacunar infarction and cerebral arerio-venous pulse wave time,and with the correlation analysis of carotid arteriosclerosis

目的观察双侧脑动静脉间脉搏波传导时间(cerebral arerio-venous pulse wave time,CAV-PWT)对腔隙性脑梗死的初步评价,及与颈动脉硬化的相关性分析。方法选择58例腔隙性脑梗死患者和43例健康体检者,采用经颅多普勒(transcranialdoppleultransonograp,TCD)仪同步监测左右两侧颈内动脉终末段(terminal internal carotid artery,TICA)与两侧基底静脉(rosenthal’s veins;venae basalis,BVR)的脉搏波,用相移方法计算CAV-PWT,比较两侧CAV-PWT的差异性;对上述人群同时进行颈动脉超声检查,分析颈动脉硬化与CAV-PWT的相关性。结果腔隙性脑梗死组患者的双侧CAV-PWT均比对照组明显缩短(P<0.05),腔隙性脑梗死组左右两侧CAV-PWT对比无明显统计学差异(P>0.05);腔隙性脑梗死组颈动脉硬化发生率均高于对照组(P<0.05),但不稳定斑块例数与对侧组相比无统计学差异。经Logistic回归结果显示:年龄、CHOL、CAV-PWT和高血压、颈动脉硬化是腔隙性脑梗死的危险因素(P<0.05)。结论腔隙性脑梗死的脑动脉硬化具有全局性,无明显同侧相关性;与颈动脉硬化具有明显相关性,但也无同侧相关性。

Objective To investigate the relationship between cerebral arerio-venous pulse wave time（ CAV-PWT）and lacunar infarction,and with the correlation analysis of carotid arteriosclerosis. Methods Fifty-eight patients with lacunar infarction and 43 sex-and-age-matched control subjects were studied. The pulse wave of terminal internal carotid artery and basal vein were simultaneously monitored by TCD and the CAV-PWT were then calculated by phase shift method. Comparing differences on both sides of CAV-PWT. To the people for carotid ultrasound at the same time,analysis the correlation of carotid atherosclerosis and CAV-PWT. Results The CAV-PWT was significantly shorten in patient group than in control group（ P〈 0. 05）. No significant statistical difference between left and right sides of the CAV-PWT contrast in the lacunar cerebral infarction. The incidence of carotid atherosclerosis was higher in patient group than in control group. But it is no statistical difference on both sides of the unstable plaques. Logistic regression analysis showed that age,cholesterol,PWT and high blood pressure were risk factors for lacunar infarction（ P〈 0. 05）. Conclusion The cerebral arteriosclerosis of Lacunar cerebral infarction has the overall importance,no significant correlation on the same side,also with the carotid atherosclerosis.