140例脑血管病经颅多普勒分析

Clinical Analysis of Transcranial Doppler on 140 Patients with Acute Cerebrovascular Diseases

目的:分析经颅多普勒(Trans-Cranial Doppler,TCD)对急性脑血管病的诊断敏感性。材料与方法:140例脑血管病患者,其中男76例,女64例,年龄20～85岁,于入院3天内均接受了TCD检查。除7例短暂性脑缺血发作者外,其余133例患者包括41例脑出血,84例脑梗塞,以及8例蛛网膜下腔出血,还经CT或腰穿证实。使用的超声诊断仪为美国产Medasonics彩色多普勒。结果:TCD较准确而及时地显示了脑血管狭窄、痉挛、闭塞,以及血管壁弹性降低等血管病变。急性脑血管病的TCD异常表现及异常率随不同病种而异,例如,脑出血主要表现为脑血管痉挛和狭窄,搏动指数升高,频谱异常,异常率82.9％,脑梗塞——脑血管严重狭窄或闭塞,频谱异常,异常率95.2％,蛛网膜下腔出血——于发病后1～7天内出现的血管痉挛是其主要伴发症,异常率62.5％,短暂性脑缺血发作——其表现相似于脑梗塞,异常率85.7％。结论:TCD对颅内动脉系统及椎一基底动脉系统的血管病变均能及时显示并准确定位。因此,它不仅对急性脑血管病具有很高的诊断敏感性,而且可用于评价某些药物的临床疗效或追踪观察。

Purpose: To analyze the diagnostic sensitivity of Transcranial Doppler (TCD)on acute cerebrovascular diseases. Materials and Methods: 140 Patients with acute cerebrovascular diseases, in whom male was 76 cases, female was 64 cases, whose age ranged between 20 and 85 years, underwent the examination of TCD within three days after be taken to hospital. Most Patients, except 7 patients with short - time cerebral ischemia attack were also proven by CT or lumbar vertebraepuncture. Ultrasonic diagnostic instrument used in this study was Medasonics color doppler made in U. S. A. Results: TCD more accurately and timely demonstrated cerebrovascular lesions such as spasm, narrowing, occlusion, and decreased elasticity of vascular wall et c. Abnormal manifestation and abnormal rate of TCD in various cerebrovascular diseases were more of less different, for example, cerebral hemorrhage mainly displayed as cerebrovascular spasm and narrowing, increased pulsation index, spectrum abnormality with 82. 9% of abnormality rate, cerebral infarction-severe cerebrovascular narrowing or occlusion,spectrum abnormality with 95. 2% of abnormality rate, subarachnoid hemorrhage--vascular spasm occurredwithin 1 - 7days after onset of clinical symptoms was an important complication with 62. 5% of abnormality, shorttime cerebral ischemia attack--the manifestation similar to cerebral infarction with 85. 7% of abnormalityrate. Conclusion: TCD could accurately and timely display vascular lesions in intracranial artery system and verteblar - basilar artery system, therefor, it not only has high diagnostic sensitivity but can be used for the evaluation or the follow up survey of therapeutic effects of some drugs.