经颅多普勒对腔隙性脑梗塞脑血管反应能力的评价

目的 :探讨改进的 CO2 麻醉气囊吸入法评价腔隙性脑梗塞脑血管的反应能力。方法 :59例经 CT或 MRI证实的腔隙性脑梗塞患者入选本试验组。常规经颅多普勒超声 (TCD)检查后 ,进入 TCD 8.0 CO2反应监测软件 ,取双侧大脑中动脉 (MCA)作监测血管 ,经改进的麻醉呼吸气囊接可充气呼吸面罩 ,使受检者吸入 5% CO2 和 95%O2 混合气体 1min诱发高碳酸血症 ,经过度换气试验诱发低碳酸血症 ,计算试验前后血流速度变化百分比。结果 :常规 TCD检查发现 :59例患者中 3 2例 (54.2 4% )有颅内血管狭窄 ,其中 MCA狭窄 3 1例 (52 .54% ) ;5% CO2 吸入和过度换气后 ,不同年龄组的腔隙性脑梗塞患者血流速度变化百分率均显著低于同年龄对照组 (P<0 .0 1)。结论 :TCD结合 CO2麻醉气囊吸入法和过度换气法评价脑血管反应能力安全可靠。腔隙性脑梗塞脑血管的反应能力下降 ,与其脑内微小动脉血管的病变有关 ,同时还存在颅内外大血管的狭窄性改变

Transcranial Doppler Evaluation of Cerebrovascular Reactivity Capacity in Lacunar Cerebral Infarction

Objective:The aim of our study was to i nvestigate the cerebrovascular reactivity capacity in patients with lacunar cere bral infarction (LCI) Methods:Fifty-nine patients with LCI confirmed by cranial C T scan or MRI were included in this study After the patients were routinely ex amined with TCD,TCD 8 0 software was performed to evaluate the cerebrovascular reactivity capacity Through modified anesthesia air sac,5% CO 2 and 95% O 2 mixed gas was inhaled to induce hypercapnia;then hypocapnia was induced by volun tary hyperventilation The changes of velocities were recorded in both middle c erebral arteries (MCA) Results:In TCD routine examination,there were 32 patients (32/59,54 24%) with intracranial artery stenoses,in which there are 31 patient s (31/59,52 54%) with MCA stenoses After 5% CO 2 inhalation and voluntary hyp erventilation,the changed percentage of velocities in two experiment groups was markedly lower than that of the control (P<0 01).Conclusions:In the patients of LCI,the capacity of cerebro vascular reactivity and reserve was decreased,not only small arteries but also l arge arteries were involved both in intracranium and extracranium