饮酒对长期酗酒者MCA血流灌注影响的TCCD对照研究

目的　探讨饮酒对长期酗酒者脑血流灌注影响的规律。方法　应用经颅彩色多普勒 (TCCD) ,对 76例酗酒者 (实验组 )及 5 2例非酗酒者 (对照组 )分别在饮酒前、饮酒后 30 min、1h、 2 h测定脑血流动力学参数 :收缩期峰值流速 (Vp)、舒张末期流速 (Vd)、平均血流速度 (Vm)、搏动指数 (PI) ,并观察频谱形态。采用同一品牌和批号的市售白酒 ,饮酒量按纯酒精折算 (0 .6 5 g/kg) ,实验于晚餐前 2 h开始 ,2 0 min内饮入。结果　 (1)酗酒者饮酒前双侧大脑中动脉 (MCA)基础血流速度 (Vp、 Vd及 Vm)均较正常减低、搏动指数 (PI)增大(P分别 <0 .0 1或 <0 .0 5 ) ,以平均血流速度 (Vm )减低最明显。血流频谱形态圆钝 ,S1 、 S2 峰融合 ,S2 >S1 。酗酒者饮酒后 30 min血流动力学参数较饮酒前变化不明显 ,1h后血流速度较饮酒前增高 (P<0 .0 1或 <0 .0 5 ) ,饮酒后 2 h各血流动力学参数基本恢复到饮酒前状态 ;(2 )非酗酒者饮酒后 30 min脑血流速度明显增高 ,1h后达到高峰 ,2 h后基本恢复到饮酒前状态 ;饮酒后脑动脉血流频谱 S1 峰较饮酒前尖耸。结论　本研究显示 :是否长期酗酒脑血流灌注情况有所不同、对急性酒精干预的反应不同 ;揭示了长期酗酒者对脑血流灌注的损害 ,对慢性酒精中毒、酒精性脑病的早期诊断和防治提供一

TCCD Investigation of Alcoholic Influence on Cerebral Blood Perfusions in Patient with Chronic Alcoholism

Objective To study the alcoholic (ethanol)influence on cerebral blood flow in patients with chronic alcoholism.Methods Some dynamic parameters in cerebral blood flow,such as Vp,Vd,Vm and PI were respectively detected and the spectral profiles were observed before and at 30,60,120 min after drinking using trancranial color Doppler(TCCD).A total of 76 patients with chronic alcoholism and 52 healthy subjects as the control group were respectively determined all the parameters.The same trademark and batch number alcohol was adopted.The amount of pure alcohol(ethanol,0.65 g/kg body weight) was drunk 2 hours before supper within 20 minutes.Results 1.The Vp,Vd and Vm of the middle cerebral arteries(MCA) on both sides were decreased but the pulsatility indices(PI) were increased.Compared with those in the control group,the above data had significant differences (P<0.01 or P<0.05),especially the Vm was reduced most significantly.S 1 and S 2 in the spectrum were mixed together and S 2 was higher than S1.The parameters from patients with chronic alcoholism at 30 min after drinking were not changed significantly.VP,Vd,Vm and PI were increased at 1 hour and recovered 2 hours after drinking.2.In the control group all these parameters were increased significantly at 30 min,reached to peak at 1hour and recovered almost at 2 hours after drinking.The peak of S 1 was high and sharp with screamed Doppler sound after drinking.The values of blood alcohol concentration were positively proportional to those changes.Conclusions This study showed that the cerebral blood perfusion in the acute test performed in the patient group was apparently different from that of the control group.We visualized that low,blunt and delayed peaks with S 1S 2 in the control group.Therefore,the cerebral perfusion in the acute test was impaired in these patients.