急性大脑中动脉主干闭塞患者的血管再通及侧支循环能力评估

目的探讨急性大脑中动脉（MCA）主干闭塞患者的脑血流变化、侧支循环代偿能力和血管再通情况。方法对78例经数字减影血管造影或磁共振血管成像证实的MCA主干闭塞患者，在急性期和随访期行经颅多普勒超声（TCD）监测。结果发病24h内TCD检测，78例（100％）病侧MCA血流信号消失，72例（92％）病侧大脑前动脉血流速度代偿性增快，6例（8％）病侧大脑后动脉血流速度代偿性增快。56例（72％）患者血管再通，21例再通1、2d，21例再通3-7d，14例再通〉7d。结论TCD有助于了解急性MCA主干闭塞患者的脑血流改变和血管再通情况，为评价治疗效果和预后提供了重要的客观依据。

Evaluation of artery recanalizatio and collateral compensative capacity in patients with acute middle cerebral artery stem occlusion

[Objective] To explore the changes of cerebral blood flow, collateral compensative capacity and the artery recanalization in patients with acute middle cerebral artery (MCA) stem occlusion. [Methods] In 78 patients with MCA stem occlusion determined by digital subtraction or MR angiography, transcranial Doppler (TCD) was measured during the acute phase and follow-up phase. [Results] TCD findings in 24 hours after clinical onset were that flow signal of lesion side MCA disappeared in 78 patients (100%), 72 patients (92%) showed blood flow velocity compensative acceleration of the lesion side anterior cerebral artery, 6 patients (8%) showed blood flow velocity compensative acceleration of the lesion side posterior cerebral artery. The artery recanalization was seen in 56 patients (72%) during 1~2 days (21 cases), 3~7 days (21 cases) and >7 days (14 cases) after stroke onset. [Conclusions] TCD may furtherly help to know the changes of cerebral blood flow and the artery recanalization in patients with acute MCA stem occlusion. It is suggested that TCD may be important and objective index in evaluating the treatment effect and the prognosis.