TCD对颈内动脉中度及重度狭窄患者脑血流动力学的评估价值

目的应用经颅多普勒超声(transcranial doppler,TCD)评价颈内动脉中度及重度狭窄患者的脑血流动力学变化。方法经数字减影血管造影(digital subtraction angiography,DSA)确诊单侧颈内动脉中度及重度狭窄的患者69例,采用TCD检测其大脑中动脉血流参数,评价其侧支循环开放情况和脑血流储备能力(CRV)。结果 TCD显示侧支循环开放者患侧收缩期峰时血流速度(Vs)、搏动指数(PI)及CVR明显高于无侧支循环开放患者(P0.05),颈内动脉中度狭窄组患侧收缩期峰时血流速度(Vs)、PI值及CVR明显高于重度组(P0.05)。结论颈内动脉狭窄时侧支开放可以改善远端血流动力学指标,但改善程度有限。TCD可检测颈内动脉狭窄患者颅内血流动力学变化,评价颅内侧支循环的建立情况,为临床治疗和评估提供可靠依据。

Analysis of cerebral hemodynamics in patients with moderate and severe carotid artery stenosis by transcranial Doppler

Objective To assess the changes of cerebral hemodynamics in patients with moderate and severe carotid artery stenosis by transcranial Doppler (TCD).Methods A total of 69 patients with internal carotid artery stenosis were divided into moderate group and severe group by digital subtraction angiography (DSA).TCD was used to detect the hemodynamic parameters of media cerebral artery and evaluate the establishment of collateral circulation and cerebral blood flow reserve capacity (CRV).Results TCD showed that the ipsilateral peak systolic flow velocity (Vs),pulsatility index (PI) and CVR in the patients with collateral circulation established were significantly higher than those of the patients without collateral circulation (P<0.05),the ipsilateral Vs,PI and CVR in internal carotid artery moderate stenosis group were significantly higher than those in severe group (P<0.05).Conclusion The establishment of collateral circulation can improve the distal hemodynamics in patients with the stenosis of internal carotid artery to some extent.TCD can detect intracranial hemodynamic changes in patients with internal carotid artery stenosis,and evaluate the collateral circulation,which can provide a reliable basis for clinical treatment and evaluation.