急性脑梗死各临床亚型患者的脑血管反应性的变化

目的 探讨急性脑梗死各临床亚型患者脑血管反应性(CVR)的变化.方法 将70例急性脑梗死患者分为3个亚组:动脉硬化性血栓形成性脑梗死(AI)组(22例)、腔隙性脑梗死(LI)组(33例)和心源性脑梗死(CI)组(15例).应用经颅多普勒超声(TCD)检测各组患者双侧大脑中动脉(MCA)的平均流速(Vm)、脉动指数(PI)、阻力指数(RI)指标,通过屏气试验测定屏气指数(BHI);并与20名正常对照组进行比较. 结果与正常对照组相比,AI组Vm、PI、RI均显著升高(P<0.05～0.01),BHI明显降低(P<0.01);LI组Vm、BHI均显著降低(均P<0.05);而CI组各参数与正常对照组相比差异无统计学意义. 结论急性脑梗死各亚组的CVR改变并不相同,AI、LI组CVR损害更为明显,CVR检测对急性脑梗死各亚型的血液动力学研究有重要意义.

Changes of cerebral vasoreactivity in patients with acute cerebral infarction of various subtypes

Objective To explore the changes of cerebral vasoreactivity(CVR) in patients with acute cerebral infarction of various clinical subtypes.Methods The 70 patients with acute cerebral infarction were divided into 3 subtypes:atherothrombotic infarction (AI)group(n=22), lacunar infarction (LI)group(n=33), cardiogenic infarction (CI)group(n=15).The mean blood flow velocity (Vm), pulse index(PI), resistance index(RI) in bilateral middle cerebral artery(MCA) were detected, and breath holding index (BHI) was measured by TCD in these patients through breath holding test. All the data were compared with the health controls. Results Compared with normal control group,the Vm,PI and RI were significantly increased (P<0.05~0.01),but BHI decreased (P<0.01) in AI group, however,Vm and BHI decreased in LI group (all P<0.05).There were no changes of each parameter in CI group (all P>0.05). Conclusions There are differents in CVR in patients with acute cerebral infarction of various subtypes. The damage of CVR is more obviously in AI and LI group. There is clinical significance for measurement of CVR to evaluate the haemodynamic changes in various subtype of acute cerebral infarction.