颈内动脉严重狭窄或闭塞的近、远段动脉血流动力学改变

目的]探讨颈内动脉严重狭窄或闭塞的近、远段动脉的血流动力学改变.方法]对121例经数字减影血管造影(DSA)或磁共振血管成像(MRI)证实的颈内动脉严重狭窄或闭塞患者(患者组)和80例无颈内动脉病变患者(对照组)行经颅多普勒超声(TCD)检测.结果]近段的颈总动脉血流波形异常,表现为收缩峰尖窄、舒张期血流速明显减低或消失或舒张早期血流逆转;与对照组比较血流速度减低,搏动指数明显增高(P＜0.01).远段的大脑中动脉血流波形异常,表现为收缩峰圆钝、舒张期血流速增高;血流速度和搏动指数明显低于对照组(P＜0.01).结论]TCD有助于了解颈内动脉严重狭窄或闭塞的近、远段动脉的血流动力学改变,为临床确定诊断和更深入研究缺血性脑血管病的发病机制提供重要的客观依据.

Hemodynamic Changes of Proximal and Distal Artery of Serious Stenosis or Occlusion of Internal Carotid Artery

Objective] To explore the hemodynamic changes of proximal and distal artery of serious stenosis or occlusion of internal carotid artery.Methods]One hundred and twenty-one patients with serious stenosis or occlusion of internal carotid artery determined by digital subtraction or MR angiography were selected to serve as patient group and eighty patients without disease of internal carotid artery were selected to serve as controls.All patients were measured by transcranial Doppler(TCD).Results]In proximal common carotid artery,TCD showed abnormal flow waveforms that manifested narrow systolic peak,diastolic flow velocity decrease or disappearance and early diastolic flow diversion.The blood flow velocity of common carotid artery was lower than controls,but its pulsitility index was significantly higher than controls(P<0.01).In distal middle cerebral artery,TCD showed abnormal flow waveforms that manifested blunt systolic peak,diastolic flow velocity acceleration.The blood flow velocity and pulsitility index of middle cerebral artery were significantly lower than controls(P<0.01).Conclusion]TCD may further help to know the hemodynamic changes of proximal and distal artery of serious stenosis or occlusion of internal carotid artery.TCD may be important and objective index in the diagnosis and pathogenesis of ischemic cerebrovascular disease.