经颅多普勒对颈内动脉颅外段重度狭窄或闭塞的颅内血流动力学分析

目的研究经颅多普勒超声（TCD）对颈内动脉颅外段重度狭窄或闭塞后颅内血流动力学参数的变化，探讨其临床应用价值。方法对32例经TCD诊断为颈内动脉颅外段重度狭窄或闭塞患者，分析其双侧大脑中动脉（MCA）、大脑前动脉（ACA）、大脑后动脉（PCA）的收缩期峰值流速（PSV）及血管搏动指数（P1），判断侧支循环开放类型，并以30例正常体检人群作为对照组，所得结果进行统计学分析。结果一侧颈内动脉颅外段重度狭窄或闭塞后，其颅内血流参数与正常对照组比较，存在明显的不对称性，经统计学t检验，差异有显著意义。TCD检测侧支循环开放例数与DSA比较，经统计学X^2检验，二者无差异（P〉0．05）。结论TCD能准确地检测到颈内动脉颅外段重度狭窄或闭塞后颅内血流动力学的变化，为临床选择治疗方法及判断预后提供有价值的信息。

Haemodynamic analysis in the patients with severe stenosis or occlusion of internal carotid artery-extracranial segments by transcranial Doppler ultrasound

Objective To analyze the haemodynamic changes in the patients with severe stenosis or occlusion of internal carotid artery-extracranial segment（ICA-ECS） by using transcranial Doppler（TCD）. Methods Thirty-two patients with severe stenosis or occlusion of ICA-ECS were evaluated by TCD and compared with 30 age-matched nomal subjects. The peak systolic velocity （PSV） and pulsatile index （PI） of the bilateral middle cerebral artery（MCA）, anterior cerebral artery（ACA）, posterior cerebral artery（PCA） were detected. All the results obtained from the both groups were statistically analyzed. Results TCD directly demonstrated that,there was a significant difference between both groups of patients and normal controls in haemodynamic changes. There was not statistic difference between TCD and DSA for detecting the patency of collateral circulation （P〉0.05）. Conclusion TCD can accurately detect the haemodynamic changes in the patients with severe stenosis or occlusion of ICA-ECS and can provide the important informations for guiding the clinical treatment and identifying the prognosis.