脑白质疏松症的经颅多普勒超声研究

目的研究脑白质疏松症(LA)的血流动力学、血流声频和频谱形态的变化,探讨经颅多普勒超声(TCD)对脑白质疏松症的评估价值。方法我院神经内科入院治疗的病人,经核磁共振成像(MRI)检查,分为LA组60例,对照组40例,两组病人的一般危险因素相匹配,并根据Fazkas视觉量表,将LA分为轻、中、重度组各20例。所有入组病人均行TCD检查,记录大脑中动脉(MCA)、大脑前动脉(ACA)、颈内动脉末端(TI-CA)、大脑后动脉(PCA)、椎动脉(VA)、基底动脉(BA)的平均血流速度(Vm)、血管搏动指数(PI)数值,血流声频及频谱形态情况。结果 LA组患者与对照组相比较,LA组患者MCA、TICA、ACA的Vm减慢,PI值增高比较差异有统计学意义;PCA、VA、BA的Vm、PI值无明显变化,差异无统计学意义。中、重度及轻、重度LA患者的MCA、TICA、ACA的Vm及PI值相比较,差异具有统计学意义,随着LA程度的增加,Vm逐渐减低,PI值逐渐增高。轻、中、重三组血流声频变化无统计学意义,频谱形态特征变化有统计学意义。结论 LA患者的MCA、TICA、ACA的Vm均减慢,PI值均增高,且与LA的严重程度呈正相关。TCD血流参数及频谱特征变化可以反映LA的严重程度。

Study of Ieukoaraiosis with Transcranial Doppler Ultrasound

Objective To investigate hemodynamic,blood flow sound frequency and spectrum morphological changes in cases with leukoaraiosis and to explore the assessment value of Transcranial Doppler ultrasound in patients with leukoaraiosis.Methods Based on brain magnetic resonace imaging diagnosis,100 patients were divided into LA group(n=60)and healthy control group(n=40).The risk factors for both groups were generally matched.Fazkas LA visual scale analysis was used to divide LA group into mild,moderate and severe level.All enrolled patients underwent inspection of TCD.The average flow velocity(Vm),vessel pulse index(PI),blood flow sound frequency and spectrum morphological changes of the middle cerebral artery(MCA),anterior cerebral artery(ACA),tail internal carotid artery(TICA),posterior cerebral artery(PCA),vertebral artery(VA) and basilar artery(BA) were recorded.Results Compared with healthy control group,the MCA,ACA,TICA blood flow velocity in the brain of LA were significantly slower in LA group while PI was significantly higher.The PCA,VA,BA had not significant changes in blood flow velocity and pulse index.Compared with moderate group,the MCA,ACA,TICA blood flow velocity in the brain of LA was significantly slower in severe group while PI were significantly higher.That was the same as compared mild group with severe group.Spectrum morphological changes showed significant difference among mild,moderate and severe group.Conclusion In patients with LA,the Vm of MCA,ACA,TICA were slower,the pulse index was higher and this trend was positively correlated with the severity of the LA.The parameter changes of Transcranial Doppler ultrasound can reflect the severity of LA.