经颅多普勒超声对焦虑症患者治疗前后脑血流变化的诊断价值

Diagnostic value of transcranial doppler on brain blood variation before and after treatment in patients with anxiety disorders

目的 探讨经颅多普勒超声对焦虑症患者治疗前后脑血流变化的诊断价值.方法 将60例焦虑症患者设为焦虑症组,经治疗后治愈的26例设为治愈组,未治愈20例设为未治愈组,选取同期进行健康体检的健康志愿者60名设为健康对照组,采用经颅多普勒超声监测受试者卧-立位大脑中动脉平均血流速度的变化.结果 焦虑症组与健康对照组卧位基线大脑中动脉平均血流速度水平比较差异无统计学意义（P〉0.05）;但焦虑症组卧-立位大脑中动脉平均血流速度之差较健康对照组明显增大（P〈0.01）.焦虑症组治疗后治愈组卧-立位脑血流速度之差较治疗前明显降低（P〈0.05）,与健康对照组比较差异无统计学意义（P〉0.05）;未治愈组卧-立位脑血流速度之差与治疗前比较差异无统计学意义（P〉0.05）,且仍显著大于健康对照组（P〈0.05）.结论 焦虑症患者脑血流自动调节功能可能存在异常,且经治愈后能够恢复,检测脑血流变化或许有助于评估焦虑症患者的疗效,判断预后.

Objective To investigate the diagnostic value of transcranial doppler on brain blood variation before and after treatment in patients with anxiety disorders. Methods 60 cases with anxiety disorders were selected as anxiety group, 26 healed patients after treatment were seen as healed group, 20 unhealed patients were seen as unhealed group, 60 healthy volunteers at the same time were selected as control group. Changes of recumbent-upright CBFV in patients were monitored by TCD. Results Difference of recumbent CBFV between anxiety group and control group had no statistic significance （P〉0.05） ; difference of recumbent-upright CBFV in anxiety group increased more significantly than control group （P 〈0.01）. Difference of recumbent-upright CBFV in anxiety group obviously declined compared with that before treatment, when compared with control group, the difference was not statistic significant （P〉0.05） difference of recumbent-upright CBFV in unhealed group had no statistic significance when compared with that before treatment （P〉0.05）, and still significantly larger than control group （P〈0.05）. Conclusion Autoregulation of cerebral blood flow in patients with anxiety disorders may be abnormal, and can be recovered after cured. Detection of brain blood variation contributes to evaluation of curative effect and prognosis.