经颅多普勒对颅内感染患者颅内压和脑灌注压的预测价值

目的 探讨经颅多普勒（TCD）频谱参数对颅内感染患者颅内压（ICP）和脑灌注压（CPP）的预测价值。方法 对42例颅内感染患者进行的128次腰穿测压前行TCD检查，对TCD资料及脑脊液压力进行分析，并与对照组比较。结果 颅内感染组患者随着ICP升高，TCD表现出高阻力血流频谱，波形普遍变尖，收缩期血流（Vs）无明显变化，舒张期血流（Vd）减慢，搏动指数（PI）增大。与对照组比较血流速度明显增快。根据TCD参数及预测ICP（ICPe）及预测CPP（CPPe）的回归方程，ICPe及CPPe值与实测的ICP、CPP值呈正相关（r=0．594、0．910，均P〈0．001）。结论 TCD频谱参数可较准确预测颅内感染患者ICP、CPP的变化。

Predictive value of transcranial Doppler for intracranial pressure and cerebral perfusion pressure in patients with intracranial infection

Objective To explore predictive value of spectra parameter changing of transcranial Doppler (TCD) for intracranial pressure (ICP) and cerebral perfusion pressure (CPP) in patients with intracranial infection. Methods TCD examination was taken before 128 times of lumbar puncture for pressure testing in 42 patients with intracranial infection. Meanwhile, Data of TCD and cerebrospinal fluid (CSF) pressure were recorded for later analysis and compared with control group.Results With ICP increase progressively , the TCD of above patients showed high resistance spectra, waveform sharpened, peak systolic velocity (Vs) without significant change while in end diastolic velocity (Vd) decreased and pulsatility index (PI) increased.Compared with control group, their blood flow velocity significantly increased.According to the TCD parameter and stepwise regression equations, predicted ICP and CPP ( ICPe and CPPe) were positive correlated with actual ICP and CPP (r=0.594,0.910, allP<0.001).Conclusion ICP and CPP can be predicted a certain extent in patients with intracranial infection according to TCD associated parameter.