TCD微栓子监测对急性脑梗死的临床价值

Clinical value of TCD microemboli monitoring for acute cerebral infarction

目的探讨经颅多普勒(TCD)微栓子监测技术对急性脑梗死患者的作用。方法选取2018-06—2018-09信阳市中心医院收治的急性脑梗死患者209例,采用MRI检查脑梗死情况,并行NIHSS评分。入院后1、3、7 d分别对患者脑动脉系统行TCD微栓子监测,统计脑动脉系统微栓子的患者数和微栓子数,出院后随访3个月采用巴氏量表评估生活能力指数。结果入院后第1、3天大面积脑梗死组患者微栓子数量和阳性率显著高于小面积脑梗死组,差异有统计学意义(P<0.05)。入院后第7天大面积脑梗死组微栓子数量和阳性率与小面积脑梗死组相比未见明显差异(P>0.05)。入院后所有患者微栓子数量和阳性率显著下降,差异有统计学意义(P<0.05)。大面积脑梗死患者入院时NIHSS评分显著高于小面积脑梗死患者,差异有统计学意义(P<0.05)。出院3个月后微栓子检测阳性患者生活能力指数评分显著低于阴性患者,差异具有统计学意义(P<0.05)。结论TCD微栓子监测能侧面反映患者脑梗死的严重程度,并且对于预测患者预后具有一定作用。

Objective To explore the role of TCD(transcranial Doppler)microemboli monitoring technology in patients with acute cerebral infarction,and to analyze its clinical application value.Methods 209 patients with acute cerebral infarction admitted to Xinyang Central Hospital from June 2018 to September 2018 were enrolled.All patients underwent MRI(nuclear magnetic resonance)to examine the cerebral infarction and the NIHSS score.TCD microemboli were performed on the cerebral arterial system of the patients 1,3,and 7 days after admission,and the number of patients with micro-emboli in the cerebral arterial system and the number of micro-emboli were counted.All patients were assessed for their ability to live with a Ba Scale by follow-up 3 months after discharge.Results The number and positive rate of microemboli in patients with large cerebral infarction on the 1st and 3rd day after admission were significantly higher than those in the small cerebral infarction group(P<0.05).The difference was statistically significant.The number and positive rate of microemboli in the large cerebral infarction group on the 7th day after admission were not significantly different from those in the small cerebral infarction group(P>0.05),and the difference was not statistically significant.The number and positive rate of microemboli were significantly decreased in all patients after admission(P<0.05),and the difference was statistically significant.NIHSS scores in patients with large cerebral infarction were significantly higher than those in small cerebral infarction patients(P<0.05),and the difference was statistically significant.After 3 months of discharge,the index of life ability index of patients with positive microemboli test was significantly lower than that of negative patients(P<0.05),and the difference was statistically significant.Conclusion TCD microemboli monitoring can reflect the severity of cerebral infarction in patients and has a certain effect on predicting the prognosis of patients.