经颅多普勒对高血压患者颅内动脉血流动力学影响的研究

目的 探讨高血压患者颅内动脉血流动力学变化，为临床治疗提供客观依据。方法收集我院确诊为高血压患者120例为研究组，另收集100例体检无高血压、高血糖、高血脂等，无心脑血管疾病史者为对照组。采用经颅多普勒检测2组患者颅内动脉血流动力学情况，检测指标包括双侧大脑中动脉（MCA）、大脑前动脉（AC）、大脑后动脉（PCA）、双侧椎动脉（VA）及基底动脉（BA）等各条血管的收缩峰值血流速度（Vp）、血管搏动指数（PI）、血管阻力指数等指标（RI）。结果研究2组血流异常109例，占90．8％，明显高于对照组（P〈0．05）。研究组各条颅内血管流速均较对照组高，左侧大脑中动脉（MCAL）、右侧大脑中动脉（MCAR）、左侧大脑后动脉（PCAL）差异有统计学意义（P〈0．05）。研究组各RI均较对照组高，其中MCAL、MCAR、左侧大脑前动脉（ACAL）、右侧大脑前动脉（ACAR）、BA差异有统计学意义（P〈0．05）。研究组PI血管搏动指数均较对照组高（P〈0．05）。结论TCD检查能有效反应高血压患者血流动力学异常改变。是一种客观、有效的检查手段，能为临床治疗提供客观、科学的依据，大大降低了高血压患者并发脑血管意外的可能。

Study on the effect of transcranial Doppler sonography on hemodynamics in patients with hypertension

Objective To investigate the change of the intracalvarium artery hemodynamics in patients with hypertension so as to provide objective evidence for the clinical treatment.Methods The 120 patients with hypertension were enrolled in the study as investigartion group,and the 100 healthy subjects who had no hypertension,hyperglycosemia,hyperlipemia,cardiovascular and cerebrovascular diseases history were enrolled in the study as control group.The transcranial Doppler was used to detect the parameters of intracalvarium artery hemodynamics including contract peak value blood flow speed,vascular pulsatility index(PI),vascular resistance index(RI) in bilateral middle cerebral artery(MCA),anterior cerebral artery(ACA),posterior cerebral artery(PCA),bilateral vertebral artery(VA) and basal artery(BA).Results 109 cases(90.8%) were abnormal for blood flow in investigation group,which were significant higher than those in control group(P<0.05).The blood flow speed in every cerebral artery in investigation group was higher than that in control group,and there were significant difference in MCAL,MCAR,PCAL between the two groups(P<0.05).The vascular resistance index in every cerebral artery in investigation group was higher than that in control group,and there were significant differences in MCAL,MCAR,ACAL,ACAR and BA between two groups(P<0.05).The vascular pulsatility index in investigation group was significantly higher than that in control group(P<0.05).Conclusion TCD is an objective and effective examination way to detect the abnormal changes of the haemodynamics in patients with hypertension,which can supply objective and scientific basis for clinical treatment,as a result,which can lower the incidence of the cerebral vascular accidents in hypertension patients.