癫痫发作间期脑动脉血流速度的变化研究

目的：了解癫痫患者脑血流速度的变化特点。方法：采用经颅超声多普勒，对43例癫痫病患者（观察组）发作间期和48例正常对照者（对照组）的脑动脉平均血流速度进行观察。结果：观察组中脑动脉平均血流速度12例正常，4例双侧增快，8例减慢，19例表现为双侧血流速度不对称，脑动脉平均血流速度异常发生率为72．09％（31／43）。对照组中，脑动脉平均血流速度33例正常，8例双侧增快，4例双侧减慢，3例表现为双侧血流速度不对称，异常率31．25％（15／48），两组异常率相比有统计学意义（P〈0．01）。结论：癫痫发作间期脑动脉血流速度存在异常改变，其异常改变的主要形式为双侧血流速度不对称和脑动脉平均血流速度减慢。     

450例头晕患者的脑动脉血流分析

本文对４５０例头晕患者及正常人２２０例进行脑动脉血流分析，结果显示头晕组的ＶＡ、ＢＡ的Ｖｐ及Ｖｍ均低于正常对照组（Ｐ＜０．０１），ＲＩ与ＰＩ多数脑动脉无显著差异，血流速度增快的检出率两组间也无明显差异。以上结果表示头晕与ＶＡ、ＢＡ血流速度减慢有关。     

癫疒间发作间期脑动脉血流速度的变化研究

目的:了解癫疒间患者脑血流速度的变化特点。方法:采用经颅超声多普勒,对43例癫疒间病患者(观察组)发作间期和48例正常对照者(对照组)的脑动脉平均血流速度进行观察。结果:观察组中脑动脉平均血流速度12例正常,4例双侧增快,8例减慢,19例表现为双侧血流速度不对称,脑动脉平均血流速度异常发生率为72.09%(31/43)。对照组中,脑动脉平均血流速度33例正常,8例双侧增快,4例双侧减慢,3例表现为双侧血流速度不对称,异常率31.25%(15/48),两组异常率相比有统计学意义(P<0.01)。结论:癫疒间发作间期脑动脉血流速度存在异常改变,其异常改变的主要形式为双侧血流速度不对称和脑动脉平均血流速度减慢。     

癫(癎)发作间期脑动脉血流速度的变化研究

目的:了解癫(癎)患者脑血流速度的变化特点.方法:采用经颅超声多普勒,对43例癫(癎)病患者(观察组)发作间期和48例正常对照者(对照组)的脑动脉平均血流速度进行观察.结果:观察组中脑动脉平均血流速度12例正常,4例双侧增快,8例减慢,19例表现为双侧血流速度不对称,脑动脉平均血流速度异常发生率为72.09%(31/43).对照组中,脑动脉平均血流速度33例正常,8例双侧增快,4例双侧减慢,3例表现为双侧血流速度不对称,异常率31.25%(15/48),两组异常率相比有统计学意义(P＜0.01).结论:癫(癎)发作间期脑动脉血流速度存在异常改变,其异常改变的主要形式为双侧血流速度不对称和脑动脉平均血流速度减慢.     

妊高征患者脑血流变化观察

应用经颅多普勒超声（ＴＣＤ）检测３５例妊高征患者（观察组）及３０例正常孕妇（对照组）的大脑中动脉（ＭＣＡ）、大脑前动脉（ＡＣＡ）、大脑后动脉（ＰＣＡ）、椎动脉（ＶＡ）、基底动脉（ＢＡ）收缩期血流速度（Ｖｓ）舒张末期血流速度（Ｖｄ）、平均血流速度（Ｖｍ）及搏动指数（ＰＩ）。结果显示：观察组中的中、重度妊高征患者脑动脉Ｖｓ、Ｖｄ均高于对照组（Ｐ＜０．０１），并随病情加重逐渐升高。观察组各条脑动脉的Ｖｍ均显著高于对照组（Ｐ＜０．０１）。观察组各条动脉ＰＩ值均显著低于对照组（Ｐ＜０．００１）。同时观察３６例妊高征患者眼底，仅３例中度及６例重度妊高征患者眼底血管有痉挛表现。说明：ＴＣＤ能检测妊高征患者脑血管痉挛所致血流速度改变，表现为血流速度加快，脑血管舒缩功能降低。ＴＣＤ能早期提供妊高征患者脑血流动力学资料，避免脑血管病危及孕妇安全。因而可作为妊高征患者预防脑血管并发症的监测手段之一。     

经颅多普勒超声评价外伤性脑血管痉挛

应用经颅多普勒超声（ＴＣＤ）检测３２例急性颅脑损伤病人颅内动脉的血流速度，并与ＣＴ扫描相对照。结果表明，如果大脑中动脉血流速度（ＶＭＣＡ）大于１２０ｃｍ／ｓ，大脑中动脉血流速度与同侧颈内动脉血流速度之比（ＶＭＣＡ／ＶＩＣＡ）大于３时，则提示伴有脑血管痉挛（ＣＶＳ），外伤性蛛网膜下腔出血量的多少与ＣＶＳ的发生有密切关系。     

植物状态,闭锁综合征和脑死亡的经颅多普勒超声检查

目的：比较植物状态（ＰＶＳ）、闭锁综合征和脑死亡患者脑血流的特点。方法：用经颅多普勒超声（ＴＣＤ）检测ＰＶＳ、闭锁综合征和脑死亡患者双侧大脑中动脉（ＭＣＡ）和基底动脉（ＢＡ）的血流情况。结果：持续植物状态ＭＣＡ和ＢＡ的平均血流速分别为２９．０ｃｍ／ｓ和２３．３ｃｍ／ｓ，较正常下降４７％和２２．３％。闭锁综合征ＭＣＡ和ＢＡ的平均血流速分别为４８．０ｃｍ／ｓ和１０．３ｃｍ／ｓ，分别较正常下降８．２％和６０．０％。提示ＰＶＳ的血流速减慢以前循环为主，而闭锁综合征的血流速减慢以后循环为主。脑死亡则为特殊的双向血流、收缩期短小尖波或无血流信号，与ＰＶＳ或闭锁综合征患者的ＴＣＤ完全不同。结论：根据前后循环血流速减慢的不同及特殊的脑血流频谱，ＴＣＤ能帮助医师鉴别上述三种临床上有时易混淆的状态     

颅内占位性病变MCA血流动力学研究

报告了６５例颅内占位病变的经颅多普勒超声波（ＴＣＤ）检测结果。大脑中动脉（ＭＣＡ）的频谱表现；平均血流速度（Ｖｍ）正常７例，双侧减慢５２例，一侧增快６例；搏动指数；正常６例，以侧增高５１例，一侧减低８例；波形；正常８例，切迹波７例，高压波４８例，衰竭波２例，此餐，有１２例存在波形的退行性改变；音频；高频杂音３例，通过文献复习，初步阐述了颅内高压引起民脑血流动力学变化的机制。     

经颅多普勒超声在脑动静脉畸形中的应用

本文报告了我院１９９１年８月至１９９２年１２月间２２例脑动静脉畸形（ＡＶＭ）经ＴＣＤ检测的结果，并观察了进行微导管栓塞（ＤＳＡ）治疗前后ＴＣＤ的变化，结果为：①检出供血动脉５１支，平均每例２、３支。检测供血动脉ＴＣＤ与ＤＳＡ造影结果相符率为９５．５％。②４例ＴＣＤ诊断困难，均为轻度者，确诊率为８１．８％。③本组血流速度增高平均为１２６．７±３３．４（ｃｍ／ｓｅｃ），ＰＩ降低，平均为０．５１，频谱异常占８１．８％，声频异常占６３．６％。④经栓塞治疗后，ＴＣＤ改变明显，血流速度平均降低２９．２（ｃｍ／ｓｅｃ），ＰＩ升高０．２５，频谱及声频均有明显好转。     

急性失血400ml对脑底动脉血流动力学及大脑神经电生理影响的观察

为观察急性失血４００ｍｌ后成人脑底动脉血流动力学及大脑神经电生理的变化，检测了失血前后的脑底主要动脉血流速度（ＶＰ）、脑电各频带功率强度和脑干听觉诱发电位（ＢＡＥＰ）主要波的潜伏期。结果：①１００例失血后左右大脑中动脉的ＶＰ分别为９９．８４ｃｍ／ｓ和９９．０４ｃｍ／ｓ；椎体动脉分别为４６．７８ｃｍ／ｓ和４６．３５ｃｍ／ｓ；基底动脉为５４．３９ｃｍ／ｓ。②９０例失血后脑电α波（ｘ）４３．６μＶ２，β波（ｘ）２０．２μＶ２，θ波（ｘ）１７．０μＶ２，δ波（ｘ）１７．６μＶ２。③９０例失血后ＢＡＥＰ的潜伏期Ⅰ波（ｘ）１．７８ｍｓ，Ⅲ波（ｘ）３．９ｍｓ，Ⅴ波（ｘ）５．８ｍｓ。所有结果与自身失血前比较均无显著差异（Ｐ＞０．０５）。提示急性失血４００ｍｌ将不影响脑底动脉血流动力学，仍可维持大脑正常神经电生理功能。     

Cerebral blood flow and CO2 reactivity in interictal migraineurs: a transcranial Doppler study

There is still some controversy about alterations in velocity of blood flow and in cerebral vasomotor reactivity of intracranial arteries in migraineurs during the interictal phase. By means of simultaneous bilateral transcranial Doppler ultrasonography we, therefore, assessed intracranial blood flow velocities and cerebrovascular reactivity to carbon dioxide of all three basal brain arteries in 20 migraineurs during the interictal phase and 30 nonheadache-prone control subjects. Mean blood flow velocities were higher in migraineurs than in controls in all three arteries on both sides, with a significant difference (P < 0.05) for the right anterior cerebral artery and middle cerebral artery under basal conditions and for the right posterior cerebral artery during hypercapnia. Similarly, the cerebrovascular reactivity to carbon dioxide was always higher in patients than in controls, with a significant difference for the left anterior and the right middle cerebral arteries (P < 0.05) and the right posterior cerebral artery (P < 0.01). The broad overlap of cerebrovascular blood flow velocities and CO2 reactivities in patients and controls precluded identification of values diagnostic of migraine. Nevertheless, transcranial Doppler ultrasonography offers the opportunity to noninvasively monitor cerebral blood flow parameters and, therefore, represents a valuable tool for vascular research in migraine.     

Transcranial Doppler evaluation of cerebral hemodynamics in migraineurs during prophylactic treatment with flunarizine

Transcranial Doppler (TCD) recording was used to evaluate the mean flow velocity (MFV) and cerebrovascular reactivity to CO2 in 21 migraineurs during the interictal phase. Nine were affected by migraine with aura (MwA) and 12 by migraine without aura (MwoA). During each session the middle cerebral artery (MCA) flow velocity was examined in basal conditions, in hypocapnia after a 3-min period of hyperventilation, in basal conditions a second time, and in hypercapnia after breath-holding. The same procedure was followed in a group of 21 age- and sex-matched volunteers. Recordings were performed before (T1), during (T2), and after (T3) prophylactic treatment with flunarizine (10 mg/day for 2 months) to assess the possible effect of this drug on cerebral hemodynamics. In basal condition, increased MFV values were found in both MwA and MwoA patients. In MwA patients the reactivity index (RI) to hypocapnia was significantly increased in T1 (p < 0.05). This abnormal cerebrovascular reactivity disappeared during flunarizine treatment (T2) and in the post-therapy period (T3).     

经颅多普勒在2型糖尿病并发脑梗死的临床应用

糖尿病(DM)是缺血性脑血管病的主要危险因素之一,并发脑梗死的发病率高且预后不良。经颅多普勒(TCD)可无创性检测脑底动脉的血流速度和搏动指数(PI)。本研究通过测定2型糖尿病(T2DM)合并脑梗死、T2DM无合并症组及健康者大脑中动脉(MCA)、颈内动脉颅外段(ICA)、基底动脉(BA)的血     

Cerebrovascular Reactivity Measured By Transcranial Doppler in Migraine

Changes in the diameter of intracranial arteries might have a major role in the pathophysiology of migraine. Though several studies have found alterations in velocity of blood flow and in cerebral vasomotor reactivity of intracranial arteries in migraineurs in headache-free periods, as well as during migraine attacks, the results are inconclusive. To determine if intracranial hemodynamic characteristics of patients with migraine differ from those of controls, we measured baseline velocity of blood flow by transcranial Doppler in the middle cerebral arteries in headache-free periods in 51 migraine patients and in 101 age-matched controls. Cerebrovascular reactivity was measured after intravenous administration of acetazolamide in 12 migrainous patients and in 19 controls. Baseline mean velocity was significantly higher in the migraine group (70 versus 65 and 72 versus 65 cm/s with P =0.02 and P =0.0007 on the left and right sides, respectively). The difference stayed significant during acetazolamide stimulation, but the course of response did not differ between controls and migraineurs. Despite statistical significance, absolute differences were small. Therefore, middle cerebral artery velocity measurements and the acetazolamide test are not useful for the diagnosis of migraine in the interictal period.     

偏头痛经颅多普勒超声与瞬目反射检查

目的探讨偏头痛血管舒缩功能障碍和神经功能障碍的关系。方法对42例偏头痛发作期和32例间歇期患者进行经颅多普勒超声(TCD)和瞬目反射(BR)检测。结果偏头痛发作期和间歇期大脑中动脉(MCA),大脑前动脉(ACA),大脑后动脉(PCA)及椎基底动脉(VA、BA)的平均血流速度(Vm)明显高于正常对照组(P<0.01),发作期的ACA、BA、VA的Vm明显高于间歇期(P<0.05);两期Vm异常率比较具有显著差异(P<0.05)。BR检测提示脑干功能障碍和三叉神经传入通路、面神经传出通路功能障碍,发作期34例(81%),间歇期24例(75%),两期异常率比较无显著差异(P>0.05)。结论偏头痛患者存在着脑干和以三叉神经为主的神经功能障碍,这很可能是造成血管舒缩功能障碍引起偏头痛发作的原因。     

献血者献血前后脑动脉血流动力学的变化

目的观察一次献血400m l对脑血流动力学的影响。方法利用经颅彩色多普勒(TCD)检测80名献血者献血前后大脑中动脉(MCA)、椎动脉(VA)、基底动脉(BA)血流速度,了解其有无差异。结果献血前后MCA、VA、BA血流速度峰值(Vp)和平均值(Vm)均无显著改变,分组统计未发现首次献血、献血史1~5年及5年以上三组献血者Vm有差异。结论一次献血400m l对脑血流动力学无影响。     

牵引按摩改善颈源性头痛脑血管机能障碍

目的：探讨牵引按摩对颈源性头痛（CH）患者脑血管机能障碍改善的机理。方法：用经颅多谱勒超声（TCD）检测125例有颈椎曲度异常或颈椎退行性改变的颈源性头痛患者牵引按摩前后与正常对照组90例的9条颅内血管（双侧大脑前、中、后动脉、椎动脉及基底动脉），并对TCD结果做统计学分析。结果：1．颈源性头痛组（125例）牵引按摩治疗后，大脑中、前动脉的平均血流速度（Vm），较治疗前降低，其值更接近于正常对照组（P〈0．05或P〈0．01）。2．治疗后颅内成对动脉的Vm差异缩小，其代表值-非对称指数（AI）的异常率以及均值显著低于治疗前，与正常对照组更接近（P〈0．01）。结论：牵引按摩治疗可双向调整颅内动脉的异常血流速度增高和减低，从而改善颈源性头痛患者的脑血管机能紊乱。     

Prediction of brain blood flow using pulsed Doppler ultrasonography in newborn lambs

The purpose of this study was to evaluate the ability of pulsed Doppler ultrasonography to predict brain blood flow by comparing measurements made in basal cerebral arteries using a pulsed Doppler system with measurements of brain blood flow using radioactive microspheres in lambs. We measured the instantaneous maximum velocity during peak systole and end diastole and the mean velocity over the pulse cycle in basal cerebral arteries, calculated Pourcelot's index of resistance and Gosling's pulsatility index, and used regression analysis to compare the pulsed Doppler measurements with brain blood flow measured with radioactive microspheres. Pulsed Doppler measurements of the peak systolic, end diastolic, and mean flow velocity in basal cerebral arteries were directly related to brain blood flow. In contrast, no linear relationship was detected between the resistance or pulsatility indices and brain blood flow measured by microspheres (p greater than 0.14). Prediction of brain blood flow for individual subjects lacks the quantitative precision necessary for use as a clinical tool. However, the direct relationship between brain blood flow and the peak systolic, end diastolic, and mean flow velocities in basal cerebral arteries supports the use of these measurements in clinical research for the qualitative assessment of change in brain blood flow.     

老年糖尿病患者脑血管病变的经颅多普勒超声分析

目的探讨经颅多普勒超声(TCD)在诊断和预测老年糖尿病患者脑血管病变中的临床应用价值.方法对32例糖尿病无脑梗死患者,31例糖尿病并脑梗死患者及31例健康者的995条脑血管,进行TCD检测,就收缩期峰血流速度(Vs)、舒张末期血流速度(Vd)、平均血流速度(Vm)、脉动指数(PI)、阻力指数(RI)值等检测;各参数的结果作比较分析.结果 3组颅内血流参数比较,两疾病组血流速度异常以Vs增快为多见,尤以颈内动脉终末端(ICA)、基底动脉(BA)异常为突出特点;两疾病组血管涡流检出率和血管条数均高于对照组;糖尿病组TCD异常率52.3%,而糖尿病合并脑梗死组57.8%,均明显高于对照组.结论 TCD检测对预测和预防糖尿病患者脑血管病发生,判断预后,指导早期治疗,预防脑梗死发生具有重要价值.