经颅多普勒与颈动脉彩超在后循环缺血病变粥样硬化斑块中的应用

目的:探讨经颅多普勒（TCD）与颈动脉彩超观察后循环缺血（PCI）病变中颅内外血管的血流动力学、颈动脉及椎动脉形态结构效果。方法:选择临床诊断为PCI颈动脉及椎动脉斑块病人48例（观察组）与无症状者38例（对照组），行TCD联合颈动脉超声检查，测量内中膜（IMT）厚度、斑块数量构成和内径大小与血流动力学特点。结果:与对照组比较，观察组存在颈动脉及椎动脉IMT增厚（P<0.01），内膜面粗糙，斑块46处，平均血流速度减慢（P<0.01），搏动指数及阻力指数增高（P<0.01）。结论:应用TCD联合颈动脉彩超可系统了解PCI病变颅内外供血情况及血管形态与结构，对PCI病变病人病因诊断、指导治疗及疗效观察具有重要的临床应用价值。

Application value of transcranial doppler combined with carotid artery color doppler ultrasound in atherosclerotic plaque of posterior circulation ischemic lesions

Objective:To investigate the value of transcranial doppler(TCD) combined with carotid artertery ultrasound in observing the hemodynamics of intracranial and extracranial blood vessels in posterior circulation ischemia(PCI) lesions,and morphological structure of carotid and vertebral artery.Methods:Forty-eight patients diagnosed by carotid artery and vertebral artery plaque(observation group) and 38 patients without symptom(control group) were examined using TCD combined with carotid ultrasound,and the intima-media thickness(IMT),plaque number composition,diameter and blood flow dynamics characteristics were measured in two groups.Results:Compared with the control group,the IMT of carotid and vertebral artery in observation group thickened(P<0.01).Compared with the control group,the intimal surface was rough,the number of plaques were 46,and the average blood flow rate decreased in observation group(P<0.01).The pulsation and resistance indexes in observation group increased compared with the control group(P<0.01).Conclusions:The application of TCD combined with carotid ultrasound can understand the blood supply of extracranial and intracranial vessels,and which has important clinical value in the etiology diagnosis,guiding treatment and observing curative effect.