短暂脑缺血发作患者的微栓子监测

目的：监测短暂脑缺血发作（ＴＩＡ）患者大脑中动脉微栓子的出现频率,了解其发病机制,确定缺血性卒中的高危人群。方法：应用德国ＥＭＥＴＣ－４０４０型经颅多普勒超声（ＴＣＤ）检测仪对４３例发病１２天以内的颈动脉系统ＴＩＡ患者进行微栓子监测,监测前常规测定颅内外各血管的血流狭窄、频谱形态及声频,以确定有无血管狭窄及狭窄部位。在病灶侧大脑中动脉的主干或于狭窄远端进行监测。监测时间每次３０～６０分钟。结果：３４例ＴＩＡ患者中发现栓子者２例占５．８８％,其中一例为大脑中动脉狭窄,另一例为修复性心脏瓣膜病患者。５例有颈部血管狭窄,１７例颅内血管狭窄。２例进展为脑梗塞者均未测到微栓子。结论：颅内血管狭窄的ＴＩＡ患者,动脉灌注损伤引起的低灌流状态在其发病机制中可能起到重要作用,而栓塞机制为次要原因。此外,大脑中动脉主干狭窄造成的局部血流紊乱,也给栓子监测带来困难。

Microembolism Detection inPatients with Transient Ischemic Attack

Objective: To study the prevalence of cerebral microembolism in patient with TIA,the risk of cerebral embolism and TIA pathogenesis. Methods: Total 34 patients were studied within 12 days after the disease onset.19 cases with hypertension,3 cases with hypertension and diabetes millitus,2 cases with atria fibrillation,1 case with prosthetic heart valve and 17 normal were searched by EMETCD soft ware version 2,3 with soundtrach and 2 MHz transducer.The microembolism were monitored in MCA mainstem for 3060 minutes.All their signals including spectra and sound were stored and identified. Results: 17 cases suffered intracranial stenosis,5 suffered extracranial vessel stenosis.Embolism signals were detected in 2 cases (588%).One patient with intracranial vascular stenosis and the other with prosthetic valve had no ischemic symptom.2 cases with multiple stenosis and infarction had no embolus being detected. Conclusion: The prevalence of microembolism is 588%(2 cases)in TIA patients.