脑栓塞病人急性期TCD异常与预后

目的 探讨脑栓塞病人急性期TCD检测在病人预后判断中的作用。方法 34例大脑中动脉(MCA)栓塞病人在病后次日行TCD检查,分析TCD参数变化与病人病后30d预后的关系。结果 脑梗死侧MCA32％无血流(11例),15％血流不对称(5例),53％血流正常(18例)。梗死侧MCA无血流者9／11(82％)预后差,而MCA血流正常者仅4/18(22％)预后差,两者差异显著。与预后好者比较,预后差者双侧MCA舒张末期血流速度(DFV)显著下降,博动扩(PI)显著增高。结论 脑栓塞病人急性期行TCD检测有助于病人预后判断。

Prognostic Value of TCD Parameters in Acute Intracerebral Embolism

Objective To investigate prognostic value of TCD in acute intracerebral embolism. Methods TCD were mearsured in 34 patients with acute intracerebral embolism. TCD parameters were obtained from both middle cerebral arteries: systolic flow velocities(SFV), diastolic flow velocities(DFV), and mean flow velocities(MFV) and Pulsatility Index (PI) from the affected and unaffected hemispheres. Mortality and Barthel index(BI)assessed at 30-day follow-up. Results TCD examination, MCA asymmetry and MCA no-flow were present in 5(14.71%) and 11(32.35%), respectively, of 34 patients; TCD findings were normal in the remaining patients. Poor functional outcome or death were 9(82%) of 11 patients with MCA no-flow, 4(22.22%) of 18 patients with normal MCA. DFV were significantly lower and PI were significantly higher in patients with poor functional outcome or death compared with patients with good functional outcome.Conclusion The TCD parameters of the MCA may be a predictor of poor functional outcome or death in patients with acute intracerebral embolism.