经颅多普勒彩超对大脑中动脉狭窄患者脑血管储备功能的临床评估

目的 用经颅多普勒超声(TCD)CO_2试验的方法,评估大脑中动脉狭窄的患者脑血管储备能力,探讨其相关的危险因素。方法 连续选取在我院住院或门诊进行TCD检查发现有大脑中动脉狭窄的患者81例,用经颅多普勒超声(TCD)CO_2试验的方法评估患者脑血管储备能力。结果 (1)81例患者中CRV(%)平均值为21.22±9.29,CRV受损患者48例(59.26%);(2)在合并缺血性卒中的症状性MCAS患者CRV低于无症状组(17.17±9.31 vs 23.61±7.85),合并糖尿病的MCAS患者CRV低于无糖尿病组(19.01±8.07 vs 23.09±9.91),合并吸烟的MCAS患者CRV低于不吸烟组(17.61±8.63 vs 22.65±9.21),差别有统计学差异(P0.05);(3)不同狭窄程度MCAS患者方差分析显示三组脑血管储备能力有统计学差异,中重度狭窄组的CRV值低于轻度狭窄组,而中度及重度狭窄组CRV比较差值无统计学差异,Spearman等级相关分析大脑中动脉狭窄患者CRV与狭窄程度存在负相关,相关系数为-0.466,P=0.001。结论 TCDCO_2试验能够用于评估大脑中动脉狭窄患者的脑血管储备,大脑中动脉狭窄程度越重CRV的受损越明显,临床上应该加强对有缺血性卒中史、糖尿病及吸烟史的MCAS患者CRV评估,以更好进行缺血性卒中的预防。

The Cerebrovascular reserve evaluation of patients with middle cerebral artery stenosis by transcranial doppler

Objective To evaluate the cerebrovascular reserve ( CRV) of patients with middle cerebral artery steno-sis(MCAS) By by transcranial Doppler (TCD)CO2 test and ivestigating risk factors of CRV impairment .Methods Eighty and one patients with MCAS were enrolled ,who received TCD assay ,The the CRV was evaluated by TCD CO 2 test.Results (1)The average of CRV(%)is was 21.22 ±9.29,CRV decreased in 48 case(59.26%).(2)The CRV of symptomatic MCAS group was significantly decreased compared to the asymptomatic group ( 17 .17 ±9 .31 vs 23 .61 ±7 .85 ) , diabetes group was significantly decreased compared to the no diabetes group (19.01 ±8.07 vs 23.09 ±9.91),smoking group was significantly decreased compared to the no smoking group (17.61 ±8.63 vs 22.65 ±9.21).(3)In Mild moderate and se-vere MCAS groups ,Analysis analysis of variance showed that there were significant differences between the three groups in CRV,The the CRV in moderate and severe stenosis group was lower than that in mild stenosis group ,There was no signifi-cant difference in CRV comparison between moderate and severe stenosis group ,Spearman rank correlation showed a nega-tive correlation between CRV and the degree of stenosis ,Correlation coefficient was -0.466,P=0.001.Conclusion TCD CO2 tests can be used to evaluate the CRV in patients with MCAS .The more severe the degree of MCA stenosis ,the more obvious the impairment of CRV was .CRV assessment of MCAS patients with ischemic stroke history ,diabetes ,and smoking history should be strengthened in order to do better prevention of ischemic stroke .