经颅多普勒超声评估老年颈内动脉闭塞患者的侧支循环代偿能力

目的　探讨经颅多普勒超声 (TCD)评估老年颈内动脉闭塞患者的侧支循环代偿能力。方法　对 80例老年一侧颈内动脉闭塞患者 ,采用TCD技术检测脑底动脉环和眼动脉的侧支循环通路。根据临床上有无脑缺血和神经功能障碍体征将患者分为症状性闭塞组 (5 4例 )和无症状性闭塞组 (2 6例 )。结果　TCD显示 93%前交通动脉侧支开放 ,5 1%后交通动脉侧支开放 ,2 5 %眼动脉侧支开放。 4例 (5 % )症状性闭塞患者未发现侧支循环 ,31例患者 (39% )1个侧支通路建立 ,36例患者 (45 % ) 2个侧支通路建立 ,9例患者 (11% ) 3个侧支通路建立。无症状性闭塞患者的大脑中动脉平均血流速度明显高于症状性闭塞患者 (P <0 .0 1)。结论　TCD有助于了解老年颈内动脉闭塞患者的侧支循环代偿能力。

Collateral compensative capacity assessed by transcranial Doppler in aged patients with internal carotid artery occlusion

Objective To assess collateral compensative capacity by transcranial Doppler(TCD) in patients with internal carotid artery occlusion .Method In 80 aged patients with unilateral internal carotid artery occlusion, collateral circulation pathway in circle of Willis and ophthalmic artery was measured by TCD.Results TCD showed collateral patency of anterior communicating artery in 93%,posterior communicating artery in 51%,and ophthalmic artery in 25%.Absence of collateral flow was found in 4 patients(5%) with symptomatic occlusion.Thirty-one patients (39%) had 1 collateral pathway,36 patients(45%) 2 collateral pathways,and 9 patients (11%) 3 collateral pathways.The mean flow velocity of middle cerebral artery in asymptomatic patients was significantly higher than that in symptomatic patients(P<0.01).Conclusions TCD can help to know the collateral compensative capacity of patients with internal carotid artery occlusion.