从正常人到脑卒中患者不同人群的脑血管血液动力学变化规律

目的　探讨从正常人至脑卒中发病前后不同时期脑血管血液动力学指标 (CVHI)的变化规律和特征。方法　研究对象选自东北、华北等地区 35岁及以上 2 5 355例脑血管病研究队列人群 ,55例急性期脑卒中患者选自南京军区福州总医院。CVHI检测为基线调查或脑卒中发病 1周内的检测结果。将研究对象分成正常人群、高危人群、脑卒中前超高危个体以及脑卒中急性期和恢复期患者等 5组。比较分析各组人群的CVHI变化规律。结果　上述 5组人群的脑血管最小血流速度 (Vmin)均值依次为 1 1 .39± 3 .2 7、9.66± 3 .1 8、6 .71± 3 .30、4 .1 3± 1 .2 7、6 .78± 3 .0 9;平均血流速度 (Vmean)和最大血流速度 (Vmax)为依次降低的变化趋势 ;而外周阻力 (RV)依次为 62 .35± 2 1 .1 1、82 .32± 31 .1 6、1 2 2 .72± 52 .73、1 37.46± 49.56、1 1 5 .89± 55 .51 ,特性阻抗 (Zcv)、脉搏波波速 (WV)、动态阻力 (DR)和临界压 (CP)等指标为依次升高的趋势。 5组CVHI积分的异常 (<75分 )发生率分别为 1 3 .3 %、34 .7%、74.1 %、1 0 0 %和 66 .7%。结论　从正常人到脑卒中高危人群及脑卒中发病的不同临床阶段 ,脑血管血流速度呈现下降趋势 ,外周阻力等指标呈上升趋势。

Changes of cerebral vascular hemodynamics from normal population to stroke

OBJECTIVE: To probe into changes of cerebral vascular hemodynamics indexes (CVHI) from normal population to different clinical stage before and after occurring of stroke. METHODS: Participants were selected from 25,355 stroke cohort study population aged 35 years and over in Northeast of China and 55 acute stroke patients were selected from Fuzhou PLA General Hospital. CVHI indexes were checked during baseline investigation or within one week after acute stroke. Participant enlisted in the study were divided into following 5 groups, normal population, high risk population, individuals before stroke, acute stroke patients and convalescence stroke patients. Characteristics of CVHI indexes in different population were analyzed and compared. RESULTS: V(min) of cerebral vascular in previous defined 5 group participants were 11.39 +/- 3.27, 9.66 +/- 3.18, 6.71 +/- 3.30, 4.13 +/- 1.27, 6.78 +/- 3.09, respectively. V(mean) and V(max) were with the same decreasing trends as V(min). However, RV in 5 group participants were 62.35 +/- 21.11, 82.32 +/- 31.16, 122.72 +/- 52.73, 137.46 +/- 49.56 and 115.89 +/- 55.51, respectively. Zcv, WV, DR and CP were also with the same increasing trends as RV. Abnormal rate of CVHI score (< 75 points) from normal population to convalescence stroke patients were 13.3%, 34.7%, 74.1%, 100% and 66.7%, respectively. CONCLUSION: From normal population to clinical stage of stroke, cerebral vascular velocity showed decreasing trends while other indexes, such as RV, Zcv, WV, DR and CP were increasing.