经颅脑多普勒在阻塞性睡眠呼吸暂停低通气综合征患者脑血管病变中的临床意义表达

Clinical significance of transcranial doppler in cerebrovascular pdisease in atients with obstructive sleep apnea hypopnea syndrome

目的分析阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者应用经颅脑多普勒(TCD)检查脑血管病变的临床意义。方法选2016年2月至2018年3月本院收治的59例OSAHS患者作为观察组,选同期59名健康体检者作为对照组,均行TCD检查,对比两组基底动脉(BA)、大脑中动脉(MCA)、椎动脉(VA)、大脑后动脉(PCA)、大脑前动脉(ACA)及脑血管狭窄、脑血管痉挛、脑动脉硬化、脑供血不足检出情况、屏气与换气过程MCA血流速度变化情况。结果观察组BA、MCA、VA、PCA、ACA的动脉脉动指数(PI)值高于对照组(P<0.05);脑血管狭窄、脑血管痉挛、脑动脉硬化、脑供血不足检出率高于对照组(P<0.05);屏气前后MCA血流速度增加率、换气前后MCA血流速度下降率低于对照组(P<0.05)。结论 TCD可通过颅内动脉血流速度与脉动指数检测OSAHS患者脑部血流灌注情况,通过屏气试验或低碳酸血症试验测定脑血管反应能力与储备能力,预测脑血管病变发生风险,能为临床针对性干预方案制定提供有价值参考。

Objective To analyze the clinical significance of transcranial Doppler(TCD)in the diagnosis of cerebrovascular disease in patients with obstructive sleep apnea hypopnea syndrome(OSAHS).Methods A total of 59 patients with OSAHS admitted to our hospital from February 2016 to March 2018 were enrolled as the observation group.59 healthy subjects were selected as control group.TCD was performed and the arterial pulsation index(PI)of the two groups was compared,including basilar artery(BA),middle cerebral artery(MCA),vertebral artery(VA),posterior cerebral artery(PCA),anterior cerebral artery(ACA),cerebrovascular disease(cerebral vascular stenosis,cerebral vasospasm,cerebral arteriosclerosis),brain cerebral insufficiency)detection,screening and ventilation process MCA blood flow velocity changes.Results The PI values of BA,MCA,VA,PCA and ACA in the observation group were higher than those in control group(P<0.05).The detection rate of cerebral vascular stenosis,cerebral vasospasm,cerebral arteriosclerosis and cerebral insufficiency in the observation group was higher than that in control group(P<0.05);The increase rate of MCA blood flow velocity before and after breath holding,and the decrease rate of MCA blood flow velocity before and after ventilation were lower than that of control group(P<0.05).Conclusion TCD can detect the blood perfusion of brain in patients with OSAHS through intracranial arterial blood flow velocity and pulsation index.The cerebral vascular response ability and reserve capacity can be measured by breath holding test or hypocapnia test to predict the risk of cerebrovascular disease.A valuable reference is provided for the development of clinically targeted interventions.