经颅多普勒（TCD）在健康查体中的检测意义

目的应用经颅多普勒（TCD）健康查体，早期发现脑供血不足、脑血管痉挛、脑动脉硬化等具有脑血管疾病发病趋势的脑血管病变，为早期预防和治疗脑血管疾病提供客观依据。方法应用TCD检测仪对300例健康体检者，使用2MHz脉冲探头，经颞窗检测大脑左右两侧中动脉（MCA）、前动脉（ACA）、后动脉（PCA），经枕窗检测基底动脉（BA）、椎动脉（VA），探测颅内主要动脉血管的血流速度、血流方向及血流性质，并观察频谱形态、脉动指数等变化；收集查体者个人信息、病史资料及目前存在的临床症状，对不同年龄段的脑血管病变及脑血管频谱形态、脉动指数、血流速度、性质等改变进行统计。结果300例被检者中，有249例（82．9％）有脑血管改变，其中有频谱形态学改变者110例，占36％；动脉硬化32例，占10．6％；VA痉挛和供血不足分别是48例和106例，各占16％和35．3％；BA痉挛和供血不足分别是18例和130例，各占6％和43％；MCA痉挛和供血不足，异常率分别是12例和88例，各占4％和29．3％。单纯ACA痉挛者多发生在30～40岁左右较年轻的人群。PCA痉挛发病率较低。在所检病例中31～50岁145例占48．3％，异常率最高，居所检脑血管病变的首位。结论通过TCD查体检测，发现脑血管疾病有逐步年轻化的趋势。早期TCD检测能及早发现脑血管疾病或有脑血管疾病发病趋势的脑血管改变，对脑血管病的发生及发展达到早期预警作用，同时对已经发生的较重的动脉硬化、椎-基底动脉痉挛及供血不足提供治疗依据。

Significance of Transcranial Doppler Detection in Health Check

Objective To detect early the cerebrovascular disorders which can develop into a cerebrovascular diseases, such as cerebral vascular insufficiency, cerebral vasospasm and cerebral arteriosclerosis, by using Transcranial Doppler （TCD） in health check,and to provide an objective basis for early prevention and treatment of cerebrovascular diseases. Methods Total 300 individuals undergoing health check were recruited and the speed, direction and character of blood flow in MCA, ACA, PCA, BA and VA were measured with TCD via temporal window and pillow window. The changes in spectral shape and pulsatility index were observed. The personal information, medical history information and present clinical symptoms of participants were collected and analyzed. Results Two hundred and forty nine cases （ 82.9% ） had cerebrovascular disease, in which 110 cases （ 36% ） s were with morphological changes of the spectrum,32 cases（ 10.6% ） with arteriosclerosis,VA spasm 48 cases（ 16% ） ,VA insuf- ficiency 106 cases（35.3% ）, BA spasm 18 cases（6% ）, BA insufficiency 130 cases（43% ）, MCA spasm 12 cases （4%）, MCA insufficiency 88 cases（29.3% ）. Pure ACA vasospasm was common in 30 -40 year-old younger crowd. The incidence of PCA spasm was relatively low. 145 cases （ 48.3 % ） of all detected individuals with cerebrovascular disorders were 31 - 50 years old, re- vealed a high prevalence. Conclusion The cerebrovascular diseases occur more and more in younger individuals. Early TCD de- tection can find the cerebrovascular diseases or cerebrovaseular disorders which should develop into a cerebrovascular disease. It can also provide a treatment basis for the existed heavier atherosclerosis and vertebral-basilar artery vasospasm or insufficient blood supply.