颅外颈动脉血流动力学改变与慢性精神分裂症患者动脉狭窄的关系研究

The relationship between hemodynamics changes of extracranial carotid artery and arterial stenosis in patients with chronic schizophrenia

目的探讨颅外颈动脉血流动力学改变与慢性精神分裂症患者动脉狭窄的关系。方法选取本院2015年6月~2017年6月本院收治的100例慢性精神分裂症患者为研究对象,根据是否伴有颈动脉狭窄分为观察组和对照组,均采用超声多普勒检查颅外颈总动脉(CCA)、颈内动脉(ICA)和椎动脉(VA),比较两组血流动力学差异。结果观察组颅外动脉收缩期峰值流速(PSV)和舒张末期流速(EDV)较对照组均显著降低(P<0.05),阻力指数(RI)较对照组均显著升高(P<0.05),且ICA的EDV预测前循环狭窄准确性(76.7%)最高,最佳截断值为20.58 cm/s,VA的EDV预测后循环狭窄准确性(80.4%)最高,最佳截断值为10.19 cm/s。结论慢性精神分裂症患者颅内动脉狭窄会引起颅外颈动脉血流呈"低速高阻"改变,其改变可在一定程度上预测颅内动脉狭窄情况。

Objective To explore the relationship between hemodynamics changes of extracranial carotid artery and arterial stenosis in patients with chronic schizophrenia. Methods A total of 100 patients with chronic schizophrenia in our hospital from June 2015 to June 2017 were selected and divided into the observation group and the control group according to whether there was carotid artery stenosis. The extracranial carotid artery （ CCA ）, internal carotid artery （ ICA ） and vertebral artery （ VA ） were examined by Doppler ultrasonography, and the hemodynamic differences were compared between the two groups. Results The peak systolic velocity （PSV） and end-diastolic velocity （EDV） of the extracranial arteries in the observation group were significantly decreased compared with those in the control group （ P 〈 0.05 ） while the resistance index （ RI ） was significantly increased compared with that in the control group （P〈0.05）. Moreover, the accuracy rate of anterior circulation stenosis by EDV prediction was the highest （76.7 % ） in ICA with the optimal cutoff value of 20.58 cm/s, and the accuracy rate of posterior circulation stenosis by EDV prediction was highest （ 80.4% ） in VA with the optimal cutoff value of 10.19 cm/s. Conclusions Intracranial arterial stenosis in patients with chronic schizophrenia can cause extracranial carotid artery blood flow with ＂low speed and high resistance＂ change, and to a certain extent the change can be used to predict intracranial artery stenosis.