脑小血管病患者经颅多普勒脑血管反应性评估

Assessment of cerebrovascular reactivity in patients with cerebral small vessel disease by transcranial Doppler

目的经颅多普勒(TCD)评估脑小血管病(CSVD)患者的脑血管反应性(CVR)。方法分析96例CSVD患者和20例健康对照者。进行TCD脑血管反应性检查和头颅磁共振(MRI)检查,TCD脑血管反应性检查诱发方式为摒气试验,检测指标为摒气指数(BHI),设BHI>0.69为正常值。结果按照Fazekas量表,将96例患者分为0级、 I级、II级、III级组共四组。结果:健康对照者BHI(例)为0.93±0.26(20例),患者组BHI(例数)分别为:0级组0.73±0.20(28例)、I级组0.63±0.16(20例)、II级组:0.52±0.18(27例)、III级组:0.38±0.19(21例)。在BHI<0.69的患者中,有58/63存在脑白质病变,而BHI>0.69的患者,有10/33存在脑白质病变。组间差异有统计学意义(P<0.05)。结论 CSVD脑白质变性患者的CVR明显降低。CVR可作为CSVD脑白质病变的辅助诊断指标。

Objective The assessment of cerebrovascular reactivity(CVR)by transcranial Doppler(TCD)in patiens with cerebral small vessel disease(CSVD).Method A retrospective analysis was performed in 96 patients with CSVD and 20 healthy controls.CVR was determined by breath holding test.The breath holding index(BHI)was calculated in standard manner and values>0.69 were considered normal.in the same period 20 healthy persons were measured.According to the Fazekas scale,the patients in the study group were divided into four groups:grade 0,gradeⅠ,gradeⅡand groupⅢ.Results The control group BHI(Number of people)were 0.93±0.26(20).in the patiens group:class 0 group 0.73±0.2(0 28),classⅠgroup:0.63±0.16(20),classⅡgroup:0.52±0.18(27),classⅢgroup:0.38±0.19(21).In patients with BHI<0.69,58/63 had white matter lesions,in patients BHI>0.69,10/33 had white matter lesions.these differences was found to be significant between groups(P<0.05).Conclusion The CVR of patients with CSVD with white matter lesions is significantly reduced.CVR can be used as an auxiliary diagnostic index for white matter lesions of CSVD.