2260米以上地区经颅多普勒超声脑血流正常值研究

目的：测定２２６０米地区健康人群ＴＣＤ正常参考值。方法：采用ＴＣＤ测定４６１例不同年龄性别世居或移居２２６０￣３８００米地区５年以上健康人颅底动脉血流速度。结果：各动脉血流速度以ＭＣＡ为最高，顺序ＭＣＡ〉ＡＣＡ〉ＢＡ〉ＶＡ〉ＰＣＡ。各动脉血流速度随年龄递减（Ｐ〈０．０１），其差率与国内外报告基本相同。脑血流速度ＭＣＡ的Ｖｄ，ＢＡ、ＶＡ的各期血流速度女性高于男性；ＰＩ偏低，ＰＩ、ＲＩ６０岁前男高于女     

经颅多普勒超声诊断要点

1982年,挪威物理学家鲁恩·艾期里德(Rune Aaslid)创立了经颅多普勒超声(transcra-nial Doppler ultrasonography,TCD)技术,他与德国 EME 公司共同开发出世界第一台经颅多普勒超声诊断仪,并应用于临床,提供了无创性检测颅内血流动力学和诊断脑血管疾病的新方法。TCD 技术具有操作简便、快速、无创伤、无射线辐射、重复性好、实用性强等特点,深受临床欢迎。近10年来,TCD 技术在基础研究,仪     

经颅多普勒超声诊断要点

根据读者要求,将“经颅多普勒超声诊断要点”重新刊登,供读者参考。     

脑电图与经颅多普勒超声在临床中的检测与分析

目的:探讨脑电图(EEG)和经颅多普勒超声(TCD)在临床检测分析的应用价值.方法:对2560例病毒性脑炎、脑血管病、癫癎、新生儿缺血缺氧性脑病、一氧化碳中毒、颅脑外伤等常见病进行EEG和TCD检测与分析.结果:治疗前25～90%的EED和TCD显示异常,治疗后除个别病例外,随着临床症状的好转和痊愈,TCD和EEG也好转或恢复正常.结论:用TCD和EEG观察常见疾病的演变过程,在指导临床进行积极正确的治疗,并且对估计预后有重要意义.     

经颅多普勒超声检查诊断

根据读者要求,将赵树元教授讲座再次刊登,供读者参考。     

经颅多普勒检测118例心律不齐频谱分析

目的：探讨经颅多普勒(TCD)检测对无任何心脏疾病临床症状的心血管患者的早期诊断。经TCD检测出心律不齐频谱图形,对于鉴别器质性心脏病和心脏神经官能症所致的TCD频谱改变有着十分重要的早期诊断价值,达到全面降低心血管事件的最终目标。方法本文收集了118例青中年心律不齐频谱患者的TCD资料,回顾性分析并与ECG作对比分析。结果发现118例青中年心律不齐的早期TCD频谱异常率为98.8%,ECG异常88.9%。两者差异有非常显著意义(<0.01),并均有不同程度的血流动力学改变。结论由于TCD能无创伤地穿透颅骨,其操作简便,重复性好,可以对患者进行连续、长时的动态观察。更重要的是它可以提供MRI、DSA、PET、SRECT等影像技术所测不到的重要血流动力学资料。     

下肢深静脉血栓的超声诊断价值及相关诊断方法的应用

目的 研究下肢深静脉血栓的超声诊断价值及相关诊断方法的应用。方法 选取2018年5月~2019年5月在我院诊治的132例下肢深静脉血栓患者临床资料,患者均采用常规超声和多普勒超声检查,比较两种诊断方法下肢静脉血栓的检出率、不同节段下肢静脉血栓灵敏度。结果 彩色多普勒超声检查下肢深静脉血栓检出率为96.21%,高于常规超声检查的80.30%,差异有统计学意义（P＜0.05）;彩色多普勒超声检查不同节段下肢深静脉血栓（股静脉、髂总静脉、腘静脉、胫后静脉、胫前静脉）灵敏性、特异性查比较,差异有统计学意义（P＜0.05）;彩色多普勒超声对股静脉（96.66）、腘静脉（92.59）的灵敏性较高,对髂总静脉、胫后静脉、胫前静脉的灵敏性较低。结论 下肢深静脉血栓采用彩色多普勒超声检出率高,且对出不同节段深静脉血栓灵敏性存在差异,无创伤,具有良好的重复性,有一定的的诊断价值。     

经颅多普勒超声对高血压病患者颅内脑底动脉检测的分析

目的 探讨经颅多普勒超声(TCD)对高血压病患者颅内脑底动脉检测的价值．方法 对194例高血压病患者经TCD检测．结果 高血压病患者的TCD具有较高的异常率，且其血流动力学改变与年龄及高血压分期有关．结论 TCD可反映高血压病患者脑底动脉病变程度，可指导临床治疗．     

彩色多普勒超声在急性下肢深静脉血栓诊断中的显像研究

目的应用彩色多普勒超声(CDFI)观察急性下肢深静脉血栓(DVT)的图像特点,研究其血流动力学变化规律。方法检测126例158条拟诊为急性下肢深静脉血栓的患者,观察下肢深静脉管腔内径变化、管壁回声、管腔内回声、血栓形成的范围、血流动力学改变等情况。结果 123条急性血栓患者初诊时下肢深静脉管腔内径患侧较健侧明显增宽(p<0.01),血栓呈低回声。完全阻塞者官腔内无彩色血流信号,彩色血流出现突然中断现象;不完全阻塞者管腔内可见彩色血流信号充盈缺损,脉冲多普勒为连续性低速血流频谱,多普勒频谱随呼吸变化不明显或无变化。结论急性下肢深静脉血栓的声像图及血流动力学改变,可为临床早期诊断提供可靠信息。     

视空间认知与脑血流速度的相关性研究

目的:探讨视觉空间认知活动对脑血流速度(CBFV)的影响及性别和任务完成质量对相对的CBFV变化的影响。方法:在完成视觉空间认知活动时及其先前的休息期,对45个正常的志愿者(右利手)用经颅超声多普勒(TCD)监测其双侧大脑中动脉血流速度的变化。结果:完成认知任务时与休息时期相比,所有认知任务的完成均诱导出双侧大脑中动脉血流速度的显著变化(P<0.001),这种变化显示出显著的右侧大脑半球偏侧化(P<0.01)。性别对认知活动所诱导的脑血流速度未产生显著的影响(P >0.05),任务表现质量(得分)对CBFV的变化不产生显著的影响。结论:视觉空间认知活动可诱导CBFV的右侧偏侧化。     

浅表动脉超声血流仪的设计

本文介绍了一种便携式浅表动脉超声多普勒血流仪的研制.该仪器可以打印出平均血流速度曲线图,也可以对多普勒血流声进行监听.文章介绍了血流速度测量原理并给出了硬件结构图和程序框图.该仪器在临床上具有广泛的用途.     

全数字超声多普勒血流测量系统研究

传统超声多普勒血流测量仪器使用模拟电路来完成信号采集与解调处理,此类系统容易受外界电磁环境、温度变化等因素的干扰,也难以运用现代信号处理技术来实现更高级的检测功能,例如多深度检测、功率M型多普勒血流成像以及编码激励成像等。本研究设计了一种全数字的超声多普勒血流信号采集处理系统,结合经典的自相关技术,实现了多深度检测和功率M型多普勒血流成像,并采用2周期基础码调制的13位Barker码编码激励方法,得到远高于传统方法的轴向空间分辨率。为验证该系统的有效性,首先利用该系统对多普勒体模进行检测实验研究,证明该系统能有效提高轴向空间分辨率;然后通过对大脑中动脉、前动脉血流检测,表明该系统可以显示出超声波发射方向上整个深度的血流信息,有利于血管的定位和识别。     

短暂性脑缺血发作患者脑血流动力学研究

目的探讨短暂性脑缺血发作(TIA)的发病机制及血流动力学变化。方法52例符合TIA诊断标准的患者入选试验组,40例健康人作对照组。对上述受检者依次进行(1)经颅多普勒超声(TCD)检查:观察颅内血管有无狭窄、闭塞、侧支循环代偿状况;(2)彩色多普勒血流显像(CDFI)检查:了解颈动脉血管有无狭窄及斑块形态改变;(3)随访1年。结果52例TIA患者中,TCD检查发现40例(76.92%,40/52)有颅内动脉狭窄,其中多发动脉狭窄(两条或两条以上血管狭窄)26例(50%,26/52),单发动脉狭窄14例(26.92%,14/52),无狭窄10例(19.23%,10/52)。CDFI检查发现35例(67.31%,35/52)有1侧或双侧颈动脉狭窄。随访1年,48例完成随访的TIA患者中,13例有脑血管事件再发(27.08%,13/48),其中颅内外血管高度狭窄者脑血管事件再发率高于中度狭窄者(P<0.05);颈动脉软斑型粥样硬化狭窄患者脑血管事件再发率高于硬斑型粥样硬化患者(P<0.05)。结论TIA的发生与颅内外动脉狭窄有关,颅内外血管狭窄程度越高,脑血管事件再发的危险性也越大。颈动脉软斑型粥样硬化斑块比硬斑型斑块更不稳定,易引起脑缺血事件。     

多普勒超声测量外周动脉血流动力学指标可信性的实验研究

用多普勒超声测量犬股动脉内径（Ｄ）、峰值流速（Ｖｐ）、平均流速（Ｖｍ）及流量（Ｑ），其结果与千分卡尺测量的内径（Ｄ′）及电磁流量计测得的峰值流速（Ｖｐ′）、平均流速（Ｖｍ′）及流量（Ｑ′）进行比较分析。结果表明：超声测得的内径与用卡尺测得的实际内径之间有良好的相关关系（ｒ＝０９１，Ｐ＜０００１）。Ｖｐ与电磁流量计测得的Ｖｐ′有较好的相关性（ｒ＝０９１，Ｐ＜０００２），Ｖｍ、Ｑ与Ｖｍ′、Ｑ′亦有相关系，但相关性稍弱（ｒ分别为０７９、０８３，Ｐ＜００５）。     

Influence of posture on middle cerebral artery mean flow velocity in humans

We determined middle cerebral artery, common carotid artery and temporal superficial artery Doppler derived flow velocities in ten subjects for 10 min after change in posture. Maximal changes were observed after about 3 min. The 10° head-down tilt position increased blood velocities in the common carotid artery by 13% (SD 4)% (P < 0.001), in the middle cerebral artery by,6% (SD 3)% (P < 0.001) and in the superficial temporal artery by 70% (SD 26)% (P < 0.001). In the standing position, there was an 18% (SD 9)% (P < 0.001) decrease in the common carotid blood velocities, with 14% (SD 6)% (P < 0.001) and 53% (SD 23)% (P < 0.001) reductions in the middle cerebral and superficial temporal artery velocities, respectively. At 9 min after the changes in posture, velocities in the middle cerebral artery were at the value of supine rest, whereas the common carotid blood velocity was not completely restored and deviations in the temporal artery velocity persisted. The data would suggest that cerebral blood flow is regulated with some delay and that such regulation is partially reflected in the common artery blood flow, since changes in a branch of the external carotid artery flow velocity remained.     

激光多普勒成像技术对体表不同部位微血流图象的初步观察

目的了解激光多普勒血流成像系统这一新的医学影象技术在人体不同部位测量中的实用价值.方法使用激光多普勒血流成像仪,对人体不同部位的微循环血流阻断、加温后的手部微循环图象予以观察,分析微循环血流图的特点及变化.结果(1)前臂内外侧面和手背、足背和腕部、额部、鼻梁和髌部的血流量分布较少,手掌的大小鱼际部位和指尖、脚趾和趾尖、口唇、颊部等部位的血流分布较多.(2)30 min内前臂、手掌和手背血流的自然波动较小.(3)上肢加压阻断后,手掌部位的血流明显减少.松解加压后,血流恢复.(4)上肢肘部给予加温,手掌部位的血流明显增加.停止加温后,血流逐渐恢复.结论激光多普勒血流成像仪能够以大范围成像方式显示体表不同部位的微循环图象和外界影响血流改变因素导致的血流变化过程.     

Blood flow velocity,erythrocyte deformability and hepatic enzymes in heavy alcohol drinkers

Significantly decreased blood flow velocity in cerebral arteries, as well as decreased erythrocyte deformability, was found in heavy alcohol drinkers (Gdovinová 2002). The aim of this study was to determine if there is any correlation between the two. At the same time, the correlation between blood flow velocity and hepatic enzymes was also studied. The study group comprised 30 male patients, who were heavy alcohol drinkers, with a mean age of 46.4 years. Mean flow velocity (Vmean) was determined by a 2 MHz pulsed Doppler probe. Erythrocyte membrane biophysical properties were estimated by cation-osmotic haemolysis (COH). Hepatic enzymes [aspartate aminotransferase (AST), alanine aminotransferase (ALT) and gamma-glutamyltransferase (GMT)] were measured in the Department of Biochemistry. The results were compared with the results from 20 healthy volunteers of the same age. Differences between the two groups were tested by Students t-test, and the relationship between blood flow velocity and COH, and of hepatic enzymes was analysed by regressive and correlative analysis. Results showed that Vmean was significantly decreased in heavy alcohol drinkers, in all cerebral arteries (the middle, anterior, and posterior cerebral arteries). No differences were noted between the left and right sides of the arteries tested. COH was similarly significantly decreased in heavy drinkers, in the medium of low (15.4 mmol/l NaCl) and high (123.2 mmol/l NaCl and above) ionic strength. Linear correlation between COH and Vmean was determined by correlative analysis, and a linear relationship was found. All hepatic enzymes (AST, ALT, GMT) were significantly increased in heavy drinkers. The relationship between Vmean and GMT was tested by the regressive analysis, and between these two parameters a linear relationship was found. It was concluded that changes in blood viscosity after the drinking of alcohol disturbs blood velocity and brain perfusion, which can be a major risk factor in strokes.     

Intra- and extracranial artery blood velocity during a sudden blood pressure decrease in humans

The intra- and extracerebral Doppler artery blood velocity responses to a 10-mmHg abrupt blood pressure (BP) decrease in ten healthy men were studied. This decrease was obtained using two cuffs placed over both thighs. First, cuffs were inflated to pressures greater than the arterial BP for 5 min. Next, they were deflated to 60 mmHg in order to prevent venous return from the legs. We obtained a decrease in mean arterial BP of from 101 (10) to 90 (10) mmHg [mean (SD), P < 0.01] without modifications in the heart rate [HR, 88 (14) beats min⁻¹]. Middle cerebral artery mean blood velocity (MCAmv) decreased immediately from 50 (10) to 42 (12) cm s⁻¹ (P < 0.05). Simultaneously, temporal superficial artery mean blood velocity (TSAmv) decreased from 11 (3) to 7 (2) cm s⁻¹ (P < 0.05) and common carotid artery blood flow (CCAbf ) decreased from 305 (23) to 233 (33) ml min⁻¹ (P < 0.05). After 5 s, MCAmv and CCAbf returned to baseline values, whereas TSAmv [8 (2) cm s⁻¹], mean arterial BP [86 (10) mmHg] remained low and HR increased [92 (12) beats min⁻¹]. TSAmv, BP and HR returned to baseline values in 1 min. These data confirm that cerebral blood flow (CBF) is very rapidly regulated but that blood flow in extracranial territories is not and that it follows the arterial BP changes. Accepted: 8 April 1997