急性前循环脑梗死患者颈内动脉内中膜厚度与血流动力学改变的关系

目的 探讨急性前循环脑梗死患者颈内动脉内-中膜厚度（intima-medial thickness，IMT）与血流动力学改变的关系。方法 采用彩色多普勒超声测量100例脑梗死患者的颈动脉分叉处I MT，研究其与颈内动脉直径（diameter，D）、收缩期峰值流速（the peak systolic velocity，PSV）、舒张末期流速（end-diastolicvelocity，EDV）、阻力指数（the resisitive index，RI）、血管搏动指数（the pulsatility index，PI）的关系，并以IMT正常、增厚、斑块形成来分组，比较各组间各血流动力学参数的差异。结果 颈内动脉双侧的IMT与RI和PI呈弱正相关性［左侧IMT（IMTL）与RI的相关系数（r）=0.269，P =0.007；右侧IMT（IMTR）与RI的r =0.211，P =0.035；IMTL与PI的r =0.267，P =0.006；IMTR与PI的r =0.205，P =0.040］，与D值、PSV、EDV比较，差异无统计学意义。IMT斑块形成组与正常组比较，RI、PI差异有统计学意义左侧R（I RIL）：（1.17±0.28）vs（1.03±0.30），P =0.036；右侧R（I RIR）：（1.16±0.33）vs（1.05±0.17），P =0.041；左侧P（I PIL）：（0.64±0.08）vs（0.59±0.12），P =0.040；右侧P（I PIR）：（0.63±0.10）vs（0.61±0.06），P =0.048]。结论 对于急性前循环脑梗死患者，IMT与颈内动脉的血流动力学部分参数RI、PI有关；通过监测IMT可以提示颈内动脉的血流动力学发生的改变，尤其是颈动脉斑块形成者的血流动力学改变。

Ralationship between Intima-medial Thickness and Hemodynamic Parameter of Iinternal Carotid Artery in Patients with Cerebral Infarction

Objective To study the relationship between intima-medial thickness （IMT） and hemodynamic parameter of internal carotid artery in patients with acute anterior circulation cerebral infarction. Methods One hundred patients of cerebral infarction were measured by color Doppler ultrasound. The IMT of the bifurcating part of carotid artery （CCA） was measured. Then the intemal carotid artery diameter, the peak systolic velocity （PSV） and minimum end-diastolic flow velocity （EDV） of internal carotid artery （ICA）, the resisitive index （RI） and the pulsatility index （PI） were measured by color Doppler ultrasound. They were compared to each other. We regarded normal of IMT as group one, thick of IMT as group two, and plaque as group three. To compare the diffenences of the hemodynamic parameters among the three groups. Results Double side IMT of internal carotid artery had a weak correlation with RI and PI （P〈0.05） Correlation coefficient between left IMT （IMTL） and RI： r=0.269, P=0.007; Correlation coefficient between right IMT（IMTR）and RI： r=0.211,P-0.035; Correlation coefficient between IMTL and PI： r=0.267, P=0.006; Correlation coefficient between 1MTR and PI： r=0.205 （P=0.040）]. Double side IMT of internal carotid artery had no significant difference with the internal carotid artery diameter, the PSV and EDV.Group plaque had a significant difference with group normal on RI and PI. Left RI（RIL） was （1.17＋0.28） vs （1.03~0.30）; right RI（RIL）was （1.16~0.33） vs （1.05~0.17）; left PI（PIL） was （0.64~0.08） vs （0.59±0.12）; right PI（PIL）was （0.63±0.10） vs （0.61±0.06）. P value was 0.036, 0.041, 0.040 and 0.048 respectively. Conclusion There is relevance between IMT and hemodynamic parameter （RI and PI） of ICA inpatients with acute anterior circulation cerebral infarction. We observe change of IMT in order to keep monitoring the hemodynamic developments of ICA, especially the plaque in the carotid artery.